Organization
NEW LIFE CENTER FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONZA SMITH (EXECUTIVE DIRECTOR)
(334) 298-0782
Entity
Organization
Contact information
Practice address
707 DILLINGHAM ST, PHENIX CITY, AL 36867-6309
(334) 298-0000
(334) 298-0519
Mailing address
707 DILLINGHAM ST, PHENIX CITY, AL 36867-6309
(334) 298-0000
(334) 298-0519
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
031801
AL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
031801
AL
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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