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NPI 1306799762

NPI 1306799762 : LIVINGSTON LODGE ALF : LIVINGSTON, NJ

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General NPI Number Information
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    NPI Number           |    1306799762
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    Entity Type          |    Organization 
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    Legal Business Name  |    LIVINGSTON LODGE ALF 
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Dates
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    Enumeration Date     |    02/17/2026
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    Last Update Date     |    02/17/2026
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Provider Practice Location Address
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    Address Line         |    68 PASSAIC AVE 
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    City                 |    LIVINGSTON
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    State                |    NJ
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    Zip                  |    07039-5811
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    Country              |    US
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    Telephone            |    973-758-4100
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    68 PASSAIC AVE 
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    City                 |    LIVINGSTON
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    State                |    NJ
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    Zip                  |    07039-5811
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SIGNER
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    Name                 |     DAVID  BARUCH 
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    Credential           |    
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    Telephone            |    201-242-4941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    
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    License Number State |    
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