New Life Foundation of PA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NEW LIFE FOUNDATION OF PA

Practice address

6701 Ogontz Ave
Philadelphia, PA 19126-2639

Phone

(215) 298-9047

Fax

(215) 298-9049

NPI assigned

Jan 12, 2018

Last updated

Jan 12, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Annette Frey, RN

Title

Administrator

Phone

(215) 298-9047

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New Life Foundation of PA Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515715200000",
    "number": "1306354212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 OGONTZ AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191262639",
            "telephone_number": "215-298-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 OGONTZ AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191262639",
            "telephone_number": "215-298-9047",
            "fax_number": "215-298-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE FOUNDATION OF PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-298-9047",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOUSING",
            "identifier": "123456",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Foundation of PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.