Provider Demographics
NPI:1699582502
Name:NEXT LIFE RECOVERY CENTER
Entity type:Organization
Organization Name:NEXT LIFE RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TROMBETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-469-7393
Mailing Address - Street 1:8110 MAXWELTON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7939
Mailing Address - Country:US
Mailing Address - Phone:470-469-7393
Mailing Address - Fax:
Practice Address - Street 1:1421 ORCHARD LAKE DR UNIT D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1475
Practice Address - Country:US
Practice Address - Phone:470-469-7393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit