| New Life Goals, Llc | |
|
504 Cooper Rd Jackson MS 39212-4704 | |
| (601) 300-3067 | |
| (601) 292-7066 |
| Full Name | New Life Goals, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 504 Cooper Rd, Jackson, Mississippi |
| Authorized Official Name and Position | Nadia L. Gaynor (CEO) |
| Authorized Official Contact | 6013003067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Goals, Llc Po Box 8113 Jackson MS 39284-8113 Ph: (601) 300-3067 | New Life Goals, Llc 504 Cooper Rd Jackson MS 39212-4704 Ph: (601) 300-3067 |
| NPI Number | 1184242711 |
|---|---|
| Provider Enumeration Date | 07/09/2020 |
| Last Update Date | 07/09/2020 |
| Certification Date | 07/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184242711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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