Provider Demographics
NPI:1871795302
Name:A NEW LIFE MENTAL HEALTH
Entity type:Organization
Organization Name:A NEW LIFE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARETA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGEAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-461-0111
Mailing Address - Street 1:1808 N MIDLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-1747
Mailing Address - Country:US
Mailing Address - Phone:208-461-0111
Mailing Address - Fax:208-461-0111
Practice Address - Street 1:1808 N MIDLAND BLVD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1747
Practice Address - Country:US
Practice Address - Phone:208-461-0111
Practice Address - Fax:208-461-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services