Provider Demographics
NPI:1962608182
Name:NEW LIFE JOURNEY, INC.
Entity type:Organization
Organization Name:NEW LIFE JOURNEY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:GRILE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-723-5014
Mailing Address - Street 1:8307 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1405
Mailing Address - Country:US
Mailing Address - Phone:804-723-5014
Mailing Address - Fax:804-723-5015
Practice Address - Street 1:7171 VERDI LN
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-6580
Practice Address - Country:US
Practice Address - Phone:804-723-5014
Practice Address - Fax:804-723-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty