Organization
NEW LIFE OF COMMUNITY HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY GAFT (VICE PRESIDENT/ADMINISTRATOR)
(215) 708-2100
Entity
Organization
Contact information
Practice address
6722 BUSTLETON AVE, PHILADELPHIA, PA 19149-2301
(215) 708-2100
(215) 708-1650
Mailing address
6722 BUSTLETON AVE, PHILADELPHIA, PA 19149-2301
(215) 708-2100
(215) 708-1650
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
100250
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016619250001
—
PA
Enumeration date
08/05/2006
Last updated
08/22/2020
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