| NPI | 1114462215 |
|---|---|
| Former Legal Business Name | NEW LIFE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DANIEL TACKLING CFO 423-434-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2024-11-06 |