Provider Demographics
NPI:1851834352
Name:NEW LIFE ADULT CARE INC
Entity type:Organization
Organization Name:NEW LIFE ADULT CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-991-9625
Mailing Address - Street 1:700 AIRPORT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2619
Mailing Address - Country:US
Mailing Address - Phone:864-991-9625
Mailing Address - Fax:864-752-1252
Practice Address - Street 1:700 AIRPORT RD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2619
Practice Address - Country:US
Practice Address - Phone:864-991-9625
Practice Address - Fax:864-752-1252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization