Healthcare Provider Details

I. General information

NPI: 1750702080
Provider Name (Legal Business Name): SHIFT TRANSITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 N RTE 17 STE 10
PARAMUS NJ
07652-2742
US

IV. Provider business mailing address

66 N RTE 17 STE 10
PARAMUS NJ
07652-2742
US

V. Phone/Fax

Practice location:
  • Phone: 201-275-0602
  • Fax: 201-275-0602
Mailing address:
  • Phone: 201-275-0602
  • Fax: 201-275-0602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. DANIEL PELTZ
Title or Position: OWNER/ PROGRAM DIRECTOR
Credential: M.ED.
Phone: 201-562-8108