New Life Adult Behavioral Services

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

Legal business name

NEW LIFE ADULT BEHAVIORAL SERVICES

Practice address

1827 W Pollack St
Phoenix, AZ 85041-6688

Phone

(702) 984-8172

NPI assigned

Sep 19, 2023

Organization subpart

No

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

Authorized official

Name

Derrick D Davis

Title

Owner

Phone

(702) 984-8172

Specialties & licenses 1

Addresses

Other names 1

• New Life Adult Behavioral Services Doing business as

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1992583140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 W NELSON AVE",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890323754",
            "telephone_number": "702-984-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 W POLLACK ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416688",
            "telephone_number": "702-984-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE ADULT BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-984-8172"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Adult Behavioral Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Behavioral Neurology & Neuropsychiatry Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavioral Neurology & Neuropsychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.