| New Life Of Love Llc | |
|
1622 N Black Canyon Hwy Unit C1 Phoenix AZ 85009-2910 | |
| (214) 907-0589 | |
| Not Available |
| Full Name | New Life Of Love Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1622 N Black Canyon Hwy Unit C1, Phoenix, Arizona |
| Authorized Official Name and Position | Kelli Childers (CEO) |
| Authorized Official Contact | 2149070589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Of Love Llc 1622 N Black Canyon Hwy Unit C1 Phoenix AZ 85009-2910 Ph: (214) 907-0589 | New Life Of Love Llc 1622 N Black Canyon Hwy Unit C1 Phoenix AZ 85009-2910 Ph: (214) 907-0589 |
| NPI Number | 1013601426 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013601426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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