| New Life Of Community Health Services, Inc. | |
|
6722 Bustleton Ave Philadelphia PA 19149-2301 | |
| (215) 708-2100 | |
| (215) 708-1650 |
| Full Name | New Life Of Community Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6722 Bustleton Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Gary Gaft (VICE PRESIDENT/ADMINISTRATOR) |
| Authorized Official Contact | 2157082100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Of Community Health Services, Inc. 6722 Bustleton Ave Philadelphia PA 19149-2301 Ph: (215) 708-2100 | New Life Of Community Health Services, Inc. 6722 Bustleton Ave Philadelphia PA 19149-2301 Ph: (215) 708-2100 |
| NPI Number | 1386653814 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6709782980 |
|---|---|
| Medicare Enrollment ID | O20031209000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386653814 | NPI | - | NPPES |
| 0016619250001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 100250 (Pennsylvania) | Primary |
| Provider Name | Ludmila A Radzievska |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275622656 PECOS PAC ID: 7618876343 Enrollment ID: I20040102000048 |
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