Organization
NEW LIFE ADDICTION COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEVERLY ANN ERVIN (CEO/DIRECTOR)
(410) 255-4475
Entity
Organization
Contact information
Practice address
2528 MOUNTAIN RD, #204, PASADENA, MD 21122-7203
(410) 255-4475
(410) 255-6277
Mailing address
2528 MOUNTAIN RD, #204, PASADENA, MD 21122-7203
(410) 255-4475
(410) 255-6277
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200731200
—
MD
Enumeration date
12/07/2011
Last updated
12/07/2011
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