Healthcare Provider Details

I. General information

NPI: 1578699450
Provider Name (Legal Business Name): THE NEW FUTURE DREAMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 7TH ST
LAKEWOOD NJ
08701-2859
US

IV. Provider business mailing address

127 7TH ST
LAKEWOOD NJ
08701-2859
US

V. Phone/Fax

Practice location:
  • Phone: 732-886-7128
  • Fax:
Mailing address:
  • Phone: 732-886-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number950020105
License Number StateNJ

VIII. Authorized Official

Name: MR. ELI SCHON
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 732-363-5672