Healthcare Provider Details

I. General information

NPI: 1720884745
Provider Name (Legal Business Name): NEW LIFE GROUP NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 QUAKERBRIDGE RD STE 2000
HAMILTON NJ
08619-1270
US

IV. Provider business mailing address

3525 QUAKERBRIDGE RD STE 2000
TRENTON NJ
08619-1270
US

V. Phone/Fax

Practice location:
  • Phone: 609-462-9430
  • Fax:
Mailing address:
  • Phone: 609-433-5506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. SETH Z TAYLOR SR.
Title or Position: CEO
Credential:
Phone: 609-433-5506