Organization
NEW LIFE BEHAVIORAL HEALTH PROGRAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN L STATEN PHD (OWNER)
(443) 270-4357
Entity
Organization
Contact information
Practice address
1818 WALBROOK AVE, BALTIMORE, MD 21217-1311
(443) 270-4357
Mailing address
3627 KEYSTONE AVE APT 4, LOS ANGELES, CA 90034-5616
(323) 309-1645
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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