Organization
A NEW WALK OF LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DAVIS (OWNER)
(561) 225-8242
Entity
Organization
Contact information
Practice address
111 AVENUE O, RIVIERA BEACH, FL 33404-7215
(561) 225-8242
Mailing address
111 AVENUE O, RIVIERA BEACH, FL 33404-7215
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/29/2016
Last updated
04/29/2016
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