| A New Life Services Inc | |
|
312 W Millbrook Rd Suite 129 Raleigh NC 27609-8147 | |
| (919) 877-6101 | |
| (919) 876-4953 |
| Full Name | A New Life Services Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 312 W Millbrook Rd Suite 129, Raleigh, North Carolina |
| Authorized Official Name and Position | Ramon Amable Fernandez (OWNER) |
| Authorized Official Contact | 9198776101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A New Life Services Inc 312 W Millbrook Rd Suite 129 Raleigh NC 27609-8147 Ph: (919) 877-6101 | A New Life Services Inc 312 W Millbrook Rd Suite 129 Raleigh NC 27609-8147 Ph: (919) 877-6101 |
| NPI Number | 1679882393 |
|---|---|
| Provider Enumeration Date | 09/29/2010 |
| Last Update Date | 12/12/2017 |
| Medicare PECOS PAC ID | 9335416072 |
|---|---|
| Medicare Enrollment ID | O20170530001862 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679882393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
| Provider Name | Eric Mizelle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780737072 PECOS PAC ID: 4486619103 Enrollment ID: I20130122000339 |
| Provider Name | Queensly I Onuzulike |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376073056 PECOS PAC ID: 1355777814 Enrollment ID: I20200203000621 |
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