Healthcare Provider Details

I. General information

NPI: 1811892193
Provider Name (Legal Business Name): NEW LIFE GROUP NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 SICKLERVILLE RD STE 1A
SICKLERVILLE NJ
08081-2636
US

IV. Provider business mailing address

521 SICKLERVILLE RD STE 1A
SICKLERVILLE NJ
08081-2636
US

V. Phone/Fax

Practice location:
  • Phone: 609-807-2483
  • Fax: 609-807-2488
Mailing address:
  • Phone: 609-913-7188
  • Fax: 609-807-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. SETH Z TAYLOR
Title or Position: CEO
Credential:
Phone: 609-433-5506