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Organization
NEW LIFE CLINIC, LLC
Active
Organization
NEW LIFE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK KENDRICK MD (PROGRAM DIRECTOR)
(859) 887-3712
Entity
Organization
Contact information
Practice address
506 N MAIN ST, NICHOLASVILLE, KY 40356
(859) 887-3712
(859) 887-2926
Mailing address
506 N MAIN ST, NICHOLASVILLE, KY 40356
(859) 887-3712
(859) 887-2926
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/01/2012
Last updated
08/17/2017
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