Provider Demographics
NPI:1871313346
Name:NEW LIFE SENIOR CARE CENTER LLC
Entity type:Organization
Organization Name:NEW LIFE SENIOR CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER (CEO)
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHRESTHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-242-8594
Mailing Address - Street 1:7410 BROADWAY FL 2
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5609
Mailing Address - Country:US
Mailing Address - Phone:347-242-8594
Mailing Address - Fax:
Practice Address - Street 1:7410 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5609
Practice Address - Country:US
Practice Address - Phone:347-242-8594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care