Provider Demographics
NPI:1154889228
Name:A NEW WAY OF LIFE LLC
Entity type:Organization
Organization Name:A NEW WAY OF LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-661-3327
Mailing Address - Street 1:1755 THE EXCHANGE SE STE 190
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-7416
Mailing Address - Country:US
Mailing Address - Phone:704-661-3327
Mailing Address - Fax:
Practice Address - Street 1:1755 THE EXCHANGE SE STE 190
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-7416
Practice Address - Country:US
Practice Address - Phone:678-707-1415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZONS UNLIMITED PROFESSIONAL SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0000OtherNONE