Organization
NEW LIFE CARE CENTER INT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAELLE SUDNEY (MANAGER)
(480) 696-9886
Entity
Organization
Contact information
Practice address
650 S COUNTRY CLUB DR APT 125, MESA, AZ 85210-2341
(480) 696-9886
Mailing address
650 S COUNTRY CLUB DR APT 125, MESA, AZ 85210-2341
(480) 696-9886
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
394330
AZ
385HR2065X
Child Physical Disabilities Respite Care
Primary
21024
AZ
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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