Provider Demographics
NPI:1992306732
Name:NEW LIFE IN HOME SERVICES, LLC
Entity type:Organization
Organization Name:NEW LIFE IN HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANTEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-226-3222
Mailing Address - Street 1:119 CHURCH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2460
Mailing Address - Country:US
Mailing Address - Phone:314-731-4800
Mailing Address - Fax:314-731-4896
Practice Address - Street 1:119 CHURCH ST STE 220
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2460
Practice Address - Country:US
Practice Address - Phone:314-731-4800
Practice Address - Fax:314-731-4896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care