Provider Demographics
NPI:1396282067
Name:NEW LIFE TREATMENT CENTER, LLP
Entity type:Organization
Organization Name:NEW LIFE TREATMENT CENTER, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BABENCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-556-1630
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:88 CEDAR STREET
Mailing Address - City:KUTTAWA
Mailing Address - State:KY
Mailing Address - Zip Code:42055-0427
Mailing Address - Country:US
Mailing Address - Phone:270-709-6529
Mailing Address - Fax:
Practice Address - Street 1:88 CEDAR ST
Practice Address - Street 2:
Practice Address - City:KUTTAWA
Practice Address - State:KY
Practice Address - Zip Code:42055
Practice Address - Country:US
Practice Address - Phone:270-709-6529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37712207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Single Specialty