Provider Demographics
NPI:1144985029
Name:A NEW MEDICAL LEVEL
Entity type:Organization
Organization Name:A NEW MEDICAL LEVEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-PROVOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-347-4718
Mailing Address - Street 1:208 DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6947
Mailing Address - Country:US
Mailing Address - Phone:337-254-6890
Mailing Address - Fax:337-332-6758
Practice Address - Street 1:1512 AMBASSADOR CAFFERY PKWY STE 5
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-1826
Practice Address - Country:US
Practice Address - Phone:337-254-6890
Practice Address - Fax:337-332-6758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care