NPIMap

Organization Active NPI

New Life Behavioral and Youth Development LLC

  • Substance Abuse Rehabilitation Facility
  • Monroe, LA
National Provider Identifier
1528564358
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
NEW LIFE BEHAVIORAL AND YOUTH DEVELOPMENT LLC
Practice address
201 Morris Ave
Monroe, LA 71202-2067
Phone
(318) 816-5514
Fax
(318) 816-5514
NPI assigned
Apr 2, 2018
Last updated
Aug 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Mr. Mark Anthony Eleam
Title
Owner
Phone
(318) 600-3962

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LA
Community/Behavioral Health Agency 251S00000X BH0012306 LA
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

201 Morris Ave
Monroe, LA 71202-2067

Mailing address

201 Morris Ave
Monroe, LA 71202-2067

Other practice location 1

301 Texas Avenue
same
Monroe, LA 71201
Phone (318) 410-8900

Other practice location 2

201 Morris Ave.
Monroe, LA 71202
Phone (318) 816-5514

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1528564358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MORRIS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MORRIS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022067",
            "telephone_number": "318-816-5514",
            "fax_number": "318-816-5514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Texas Avenue",
            "address_2": "same",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "71201",
            "country_code": "US",
            "telephone_number": "318-410-8900",
            "fax_number": "318-410-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Morris Ave.",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "71202",
            "country_code": "US",
            "telephone_number": "318-816-5514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW LIFE BEHAVIORAL AND YOUTH DEVELOPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "ELEAM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-600-3962",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "BH0012306",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.