| New Life 360, Inc. | |
|
13927 Smiling Daisy Pl Riverview FL 33579 | |
| (734) 890-9291 | |
| Not Available |
| Full Name | New Life 360, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 13927 Smiling Daisy Pl, Riverview, Florida |
| Authorized Official Name and Position | Jamaca Bradley (CLINICAL THERAPIST) |
| Authorized Official Contact | 7348909291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life 360, Inc. 13927 Smiling Daisy Pl Riverview FL 33579 Ph: (734) 890-9291 | New Life 360, Inc. 13927 Smiling Daisy Pl Riverview FL 33579 Ph: (734) 890-9291 |
| NPI Number | 1861214850 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861214850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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