Provider Demographics
NPI:1205385929
Name:NEW CONCEPTS FOR LIVING
Entity Type:Organization
Organization Name:NEW CONCEPTS FOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-843-3427
Mailing Address - Street 1:68A W PASSAIC ST
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3216
Mailing Address - Country:US
Mailing Address - Phone:201-843-3427
Mailing Address - Fax:
Practice Address - Street 1:195 POMPTON RD
Practice Address - Street 2:
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-1665
Practice Address - Country:US
Practice Address - Phone:973-595-1137
Practice Address - Fax:973-595-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0496154Medicaid