Healthcare Provider Details
I. General information
NPI: 1164046892
Provider Name (Legal Business Name): ITS A NEW DAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2020
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 WALNUT DR
TENAFLY NJ
07670-2836
US
IV. Provider business mailing address
PO BOX 516
TENAFLY NJ
07670-0516
US
V. Phone/Fax
- Phone: 201-723-1616
- Fax: 201-568-8046
- Phone: 201-723-1616
- Fax: 201-568-8046
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEBRA
A
AUSLANDER
Title or Position: DIRECTOR
Credential: M.ED.,BCBA
Phone: 201-913-1144