Healthcare Provider Details

I. General information

NPI: 1467898056
Provider Name (Legal Business Name): NEW CONCEPTS FOR LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68A W PASSAIC ST
ROCHELLE PARK NJ
07662-3216
US

IV. Provider business mailing address

68A W PASSAIC ST
ROCHELLE PARK NJ
07662-3216
US

V. Phone/Fax

Practice location:
  • Phone: 201-843-3427
  • Fax: 201-843-3639
Mailing address:
  • Phone: 201-843-3427
  • Fax: 201-843-3639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. RACHEL SHEMESH
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 201-843-3427