Organization
NUEVA VIDA MENTAL HEALTH CENTER
Active
Organization
NUEVA VIDA MENTAL HEALTH CENTER
Active
Other names
NUEVA VIDA BEHAVIORAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GODRHAT P SHOLEVAR MD (EXECUTIVE DIRECTOR)
(215) 229-0956
Entity
Organization
Contact information
Practice address
618 W LEHIGH AVE, PHILADELPHIA, PA 19133-2227
(215) 229-8857
(215) 229-0654
Mailing address
618 W LEHIGH AVE, PHILADELPHIA, PA 19133-2227
(215) 229-8857
(215) 229-0654
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016954870003
PROMISE NUMBER
PA
Enumeration date
01/24/2007
Last updated
09/10/2012
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