# NEW LIFE FAMILY SERVICES, INC.

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

## Provider details

- **NPI number:** 1952429391
- **Authorized official:** MR. TERENCE DENARD MITCHELL B.S., QP (CEO)
- **Authorized official phone:** (434) 774-6591

## Contact information

- **Practice address:** 1014 GRAYS LAND CT, SUITE 617, KERNERSVILLE, NC 27284-0054
- **Practice address phone:** (434) 774-6591
- **Practice address fax:** (336) 691-5055
- **Mailing address:** 1014 GRAYS LAND CT, SUITE 617, KERNERSVILLE, NC 27284-0054
- **Mailing address phone:** (434) 774-6591
- **Mailing address fax:** (336) 691-5055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | — | NULL | — |
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | Yes |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-041-643 | NC | — |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 01/03/2020