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Organization
NEW LIFE OF COMMUNITY HEALTH SERVICES, INC.
Active
Organization
NEW LIFE OF COMMUNITY HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY GAFT (VICE PRESIDENT/ADMINISTRATOR)
(215) 708-2100
Entity
Organization
Contact information
Practice address
6722 BUSTLETON AVE, PHILADELPHIA, PA 19149-2301
(215) 708-2100
(215) 708-1650
Mailing address
6722 BUSTLETON AVE, PHILADELPHIA, PA 19149-2301
(215) 708-2100
(215) 708-1650
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
100250
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016619250001
—
PA
Enumeration date
08/05/2006
Last updated
08/22/2020
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