Organization
NEW LIFE FOR WOMEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GIBBONS LCSW (CLINICAL DIRECTOR)
(601) 355-2195
Entity
Organization
Contact information
Practice address
814 N CONGRESS ST, JACKSON, MS 39202-2551
(601) 355-2195
(601) 354-4193
Mailing address
814 N CONGRESS ST, JACKSON, MS 39202-2551
(601) 355-2195
(601) 354-4193
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
08/13/2013
Last updated
09/04/2014
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