New Life 360 Inc-Riverview

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

NEW LIFE 360 INC-RIVERVIEW

Practice address

13927 Smiling Daisy PL
Riverview, FL 33579

Phone

(734) 890-9291

NPI assigned

Oct 30, 2024

Organization subpart

No

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

Authorized official

Name

Jamaca Bradley, LCSWNPI 1407678485

Title

Clinical Therapist

Phone

(734) 890-9291

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Jamaca Bradley, LCSW

  • Clinical Social Worker
  • Riverview, FL
  • NPI 1407678485
  NPD Authorized official

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1861214850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13927 SMILING DAISY PL",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33579",
            "telephone_number": "734-890-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13927 SMILING DAISY PL",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33579",
            "telephone_number": "734-890-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE 360 INC-RIVERVIEW",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "JAMACA",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "734-890-9291",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Lynette Nevarez, D.M.D.
• Ann Nevin, APRN, FNP-BC
• New Beginning Addiction and Wellness Center
• New Beginning Addiction and Wellness Center
• New Horizon Support Services Inc
• Next Level Care Circle Inc
• Next Level Hydration Inc
• Next Steps Learning
• Nextgen Wellness Institute LLC
• Nexus Spine Institute, LLC

• Adult Mental Health Clinic/Center in Riverview, FL
• Providers in Riverview, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.