Organization
NEW LIFE RECOVERY FOUNDATION CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENNIETH MCCORMICK (CEO)
(410) 908-3106
Entity
Organization
Contact information
Practice address
302 PARK AVE, BALTIMORE, MD 21201-3618
(410) 304-6686
(443) 836-9157
Mailing address
302 PARK AVE, BALTIMORE, MD 21201-3618
(410) 304-6686
(443) 836-9157
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
06/09/2023
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