Organization
NEW LIFE MENTAL MANAGEMENT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IHOSVANY ESCOBAR (VICE PRESIDENT)
(786) 457-1263
Entity
Organization
Contact information
Practice address
3904 NW 167TH ST, OPA LOCKA, FL 33054-6233
(305) 393-5303
(305) 513-9338
Mailing address
3904 NW 167TH ST, OPA LOCKA, FL 33054-6233
(305) 393-5303
(305) 513-9338
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685797
—
FL
Enumeration date
09/28/2017
Last updated
07/21/2022
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