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New Life Community Group Home, Inc.
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Winston-Salem, North Carolina
NPI 1194814038

New Life Community Group Home, Inc. is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Winston-Salem, NC. New Life Community Group Home, Inc. practices in Winston-Salem, NC. The NPI Number for New Life Community Group Home, Inc. is 1194814038 and holds a License No. MHL-034-202 (North Carolina).

The current practice location address for New Life Community Group Home, Inc. is 2885 Marshallberg Street, Winston-Salem, NC and can be reached out via phone at 336-595-4501.

Location: 2885 Marshallberg Street, Winston-Salem, NC, 27105
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1194814038
Provider Name
New Life Community Group Home, Inc.
Credential
Provider Entity Type
Organization
Address
2885 Marshallberg Street, Winston-Salem, NC, 27105
Phone Number
336-595-4501
Fax Number
Provider Enumeration Date
10/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3408142 05 NC
institution
Provider Business Practice Location Address Details
Address
2885 Marshallberg Street
City
Winston-Salem
State
North Carolina
Zip
27105
Phone Number
336-595-4501
Fax Number
person
Provider Business Mailing Address Details
Address
2885 Marshallberg Street
City
Winston-Salem
State
North Carolina
Zip
27105
Phone Number
336-595-4501
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
MHL-034-202 (North Carolina)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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