Provider Demographics
NPI:1043806524
Name:NEW CHANCE REHAB LLC
Entity type:Organization
Organization Name:NEW CHANCE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBERTS-PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-533-3309
Mailing Address - Street 1:3990 VALLEY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1531
Mailing Address - Country:US
Mailing Address - Phone:626-533-3309
Mailing Address - Fax:
Practice Address - Street 1:3990 VALLEY BLVD STE A
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-1531
Practice Address - Country:US
Practice Address - Phone:626-533-3309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health