Organization
MY NEW LIFE FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMARIA LASHUNG HENRY (CEO)
(404) 437-2593
Entity
Organization
Contact information
Practice address
1607 RALPH DAVID ABERNATHY BLVD SW, ATLANTA, GA 30310-1237
(404) 437-2593
(404) 228-7957
Mailing address
1582 WESTWOOD AVE SW, ATLANTA, GA 30310-2366
(404) 437-2593
(404) 228-7957
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/17/2012
Last updated
11/15/2012
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