Organization
NEW LIFE RESIDENTIAL&COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRARESE SANDERS (DOO)
(330) 327-2637
Entity
Organization
Contact information
Practice address
1230 37TH ST NE APT D, CANTON, OH 44714-1340
(330) 412-0528
Mailing address
1230 37TH ST NE APT D, CANTON, OH 44714-1340
(330) 412-0528
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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