Provider Demographics
NPI:1124900733
Name:NEW LIFE RTF LLC
Entity type:Organization
Organization Name:NEW LIFE RTF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ITORO
Authorized Official - Middle Name:
Authorized Official - Last Name:ETUKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-704-0286
Mailing Address - Street 1:1340 NW SHADY LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1738
Mailing Address - Country:US
Mailing Address - Phone:503-454-8173
Mailing Address - Fax:541-704-0336
Practice Address - Street 1:1340 NW SHADY LN
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1738
Practice Address - Country:US
Practice Address - Phone:503-454-8173
Practice Address - Fax:541-704-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health