NEW LIFE RECOVERY CLINIC 2 NPI 1528711801

NPI Information

NEW LIFE RECOVERY CLINIC 2 is a general practice in Beachwood, OH. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee NEW LIFE RECOVERY CLINIC 2 NPI is 1528711801. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

25201 CHAGRIN BLVD STE 390
BEACHWOOD, OH
ZIP 44122-637
Phone: (216) 770-3130
Fax: (216) 770-3100

The provider's authorized official is Akari Tichavakunda .
The authorized official title is Owner and has the following contact phone number (216) 770-3130.

The enumeration date for this NPI number is 1/27/2022 and was last updated on 1/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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