Provider Demographics
NPI:1811585508
Name:NEW LIFE GROUP NJ LLC
Entity type:Organization
Organization Name:NEW LIFE GROUP NJ LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:Z
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:609-913-7188
Mailing Address - Street 1:3642 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-2612
Mailing Address - Country:US
Mailing Address - Phone:609-913-7188
Mailing Address - Fax:609-571-1942
Practice Address - Street 1:127 206 SOUTH SUITE 19A&B
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2612
Practice Address - Country:US
Practice Address - Phone:609-913-7188
Practice Address - Fax:609-807-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities