Healthcare Provider Details

I. General information

NPI: 1376089383
Provider Name (Legal Business Name): NUE BEGINNINGS RESIDENCE HOME A NJ NONPROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1442 SHIRLEY ST
PLAINFIELD NJ
07062-2131
US

IV. Provider business mailing address

1442 SHIRLEY ST
PLAINFIELD NJ
07062-2131
US

V. Phone/Fax

Practice location:
  • Phone: 678-481-9844
  • Fax:
Mailing address:
  • Phone: 678-481-9844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training 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: MARVIN CHAMBERS
Title or Position: TRUSTEE
Credential:
Phone: 678-481-9844