| Newlife Behavioral Health, Llc | |
|
4133 Painted Arabian Run Deforest WI 53532-8803 | |
| (608) 707-7880 | |
| Not Available |
| Full Name | Newlife Behavioral Health, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4133 Painted Arabian Run, Deforest, Wisconsin |
| Authorized Official Name and Position | Wagdy Khalil (OWNER) |
| Authorized Official Contact | 9736186856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newlife Behavioral Health, Llc 4133 Painted Arabian Run Deforest WI 53532-8803 Ph: (608) 707-7880 | Newlife Behavioral Health, Llc 4133 Painted Arabian Run Deforest WI 53532-8803 Ph: (608) 707-7880 |
| NPI Number | 1447015920 |
|---|---|
| Provider Enumeration Date | 02/14/2024 |
| Last Update Date | 02/14/2024 |
| Certification Date | 02/14/2024 |
| Medicare PECOS PAC ID | 3173962024 |
|---|---|
| Medicare Enrollment ID | O20240411004288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447015920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Wagdy A Khalil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043507031 PECOS PAC ID: 3274750864 Enrollment ID: I20190406000051 |
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