Provider Demographics
NPI:1194403022
Name:NEW AGE CARE LLC
Entity type:Organization
Organization Name:NEW AGE CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SOUALIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-508-4799
Mailing Address - Street 1:25 BROADWAY FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-1082
Mailing Address - Country:US
Mailing Address - Phone:929-508-4799
Mailing Address - Fax:
Practice Address - Street 1:25 BROADWAY FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1082
Practice Address - Country:US
Practice Address - Phone:929-508-4799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health