# NEW LIFE CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356695100
- **Authorized official:** DR. JACK KENDRICK MD (PROGRAM DIRECTOR)
- **Authorized official phone:** (859) 887-3712

## Contact information

- **Practice address:** 506 N MAIN ST, NICHOLASVILLE, KY 40356
- **Practice address phone:** (859) 887-3712
- **Practice address fax:** (859) 887-2926
- **Mailing address:** 506 N MAIN ST, NICHOLASVILLE, KY 40356
- **Mailing address phone:** (859) 887-3712
- **Mailing address fax:** (859) 887-2926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |

## Other

- **Enumeration date:** 11/01/2012
- **Last updated:** 08/17/2017