New Life 360 Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

NEW LIFE 360 INC

Practice address

1047 E Brandon Blvd
Brandon, FL 33511-5515

Phone

(813) 548-1166

NPI assigned

Aug 29, 2018

Organization subpart

No

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

Authorized official

Name

Sherry Bradley, LCSWNPI 1811254089

Title

Ceo

Phone

(734) 658-5055

Specialties & licenses 1

Addresses

Tax ID family

New Life 360 Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New Life 360 Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brandon, FL
  • NPI 1194205542
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sherry J Bradley, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Brandon, FL
  • NPI 1811254089
  NPD Authorized official
• Kimberly M Meek

  • Clinical Social Worker
  • Brandon, FL
  • NPI 1114671807
  NPD (past)

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1417439282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 E BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115515",
            "telephone_number": "813-548-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 E BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115515",
            "telephone_number": "813-548-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE 360 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-658-5055",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• New Horizons Group Homes, Inc.
• New Journey Counseling Center LLC
• New Life 360 Inc.
• New Life 360 Temple Terrace Inc
• New Life Adult Care II, Inc
• New Life Home Care Inc
• Amanda L Newcity, DMD

• Substance Use Disorder Rehabilitation Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.