MEDICARE: LIVINGSTON LODGE ALF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1306799762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVINGSTON LODGE ALF

Provider Business Mailing Address
First Line	:	68 PASSAIC AVE
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-5811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 PASSAIC AVE
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-5811
Country	:	US
Telephone Number	:	973-758-4100
Fax Number	:

Authorized Official
Title or Position	:	SIGNER
Name	:	DAVID BARUCH
Credential	:
Telephone Number	:	201-242-4941

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “LIVINGSTON LODGE ALF ” Practice Location

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