Healthcare Provider Details
I. General information
NPI: 1407062409
Provider Name (Legal Business Name): NEW LIFE ADULT MEDICAL DAY CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
340 EVELYN ST
PARAMUS NJ
07652-2908
US
IV. Provider business mailing address
340 EVELYN ST
PARAMUS NJ
07652-2908
US
V. Phone/Fax
- Phone: 201-265-0606
- Fax: 201-265-0630
- Phone: 201-265-0606
- Fax: 201-265-0630
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | 15W32J |
| License Number State | NJ |
VIII. Authorized Official
Name: MS.
ZHANNA
ALERGANT
Title or Position: PRESIDENT
Credential:
Phone: 201-265-0606