Organization
ANEW LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADINE ROUSSEAU CNP (CEO)
(508) 991-9024
Entity
Organization
Contact information
Practice address
59 FLETCHER ST, BROCKTON, MA 02302-2015
(508) 991-9024
Mailing address
59 FLETCHER ST, BROCKTON, MA 02302-2015
(508) 991-9024
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/03/2022
Last updated
04/03/2022
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