Innovative Life Of New Jersey
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Willingboro, New Jersey
1316614092- Practice location
- 88 Club House Dr, Willingboro, NJ 08046-3404
- Phone
- 301-270-4750
- Fax
- —
- Last updated
- August 30, 2021
Innovative Life Of New Jersey is a healthcare organization based in Willingboro, NJ. Innovative Life Of New Jersey practices in Willingboro, NJ. The NPI Number for Innovative Life Of New Jersey is 1316614092. The current practice location address for Innovative Life Of New Jersey is 88 Club House Dr, Willingboro, NJ 08046-3404 and can be reached out via phone at 301-270-4750.
Provider Profile Details
- NPI Number
- 1316614092
- Provider Name
- Innovative Life Of New Jersey
- Provider Entity Type
- Organization
- Address
- 88 Club House Dr, Willingboro, NJ 08046-3404
- Phone Number
- 301-270-4750
- Primary Taxonomy
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · 320900000X
- Organization Subpart
- No
- Authorized Official
- Shinavia Mckinney · Coo · 301-270-4750
- Provider Enumeration Date
- August 30, 2021
- Last Update Date
- August 30, 2021
- Certification Date
- August 10, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 88 Club House Dr
Willingboro, NJ 08046-3404 - City
- Willingboro
- State
- New Jersey
- Zip
- 08046-3404
- Phone Number
- 301-270-4750
Provider Business Mailing Address Details
- Address
- 8484 Georgia Ave Ste 900
Silver Spring, MD 20910-5604 - City
- Silver Spring
- State
- MD
- Zip
- 20910-5604
- Phone Number
- 301-270-4750
License Information
- Taxonomy
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · 320900000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Innovative Life Of New Jersey?
The NPI number of Innovative Life Of New Jersey is 1316614092. It was assigned on August 30, 2021 and is currently active in the NPPES registry.
What is the specialty of Innovative Life Of New Jersey?
Innovative Life Of New Jersey is registered under the primary taxonomy Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (code 320900000X).
Where does Innovative Life Of New Jersey practice?
The practice location is 88 Club House Dr, Willingboro, NJ 08046-3404. The office can be reached at 301-270-4750 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316614092 directly on the NPPES registry website.