NPIMap

Organization Active NPI

New Life Recovery Center LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1679210967
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
NEW LIFE RECOVERY CENTER LLC
Practice address
102 Saint Paul St
Baltimore, MD 21202-1704
Phone
(240) 253-3663
Fax
(443) 836-9157
NPI assigned
May 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Mr. Vennieth McCormick
Title
Executive Director
Phone
(240) 253-3663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

102 Saint Paul St
Baltimore, MD 21202-1704

Mailing address

302 Park Ave Ste 1
Baltimore, MD 21201-3618
Phone (240) 253-3663

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vennieth@newliferecoverycenter.org

National Provider Directory

National Provider Directory
Tax ID family
New Life Recovery Center LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

302 Park Ave
Ste 1
Baltimore, MD 21201

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1679210967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PARK AVE STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013618",
            "telephone_number": "240-253-3663",
            "fax_number": "443-836-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212021704",
            "telephone_number": "240-253-3663",
            "fax_number": "443-836-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "VENNIETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "240-253-3663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vennieth@newliferecoverycenter.org",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "address_1": "5016 Queensberry Ave",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212155119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.