Organization
YOUTH FOR TOMORROW NEW LIFE CENTER, INC.
Active
Organization
YOUTH FOR TOMORROW NEW LIFE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI PEREZ (CONTROLLER)
(703) 636-5100
Entity
Organization
Contact information
Practice address
11835 HAZEL CIRCLE DR, BRISTOW, VA 20136-2180
(703) 636-5100
(703) 361-4335
Mailing address
11835 HAZEL CIRCLE DR, BRISTOW, VA 20136-2180
(703) 636-5100
(703) 361-4335
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316118292
—
VA
Enumeration date
01/22/2019
Last updated
01/22/2019
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