Provider Demographics
NPI:1275907826
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:
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 1:68A W PASSAIC ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3216
Practice Address - Country:US
Practice Address - Phone:201-843-3427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ222447934251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1255711479Medicaid
NJ1346620747Medicaid
NJ1780064188Medicaid
NJ1528448925Medicaid
NJ1578943973Medicaid
NJ1780081943Medicaid
NJ1992185110Medicaid
NJ1659751063Medicaid
NJ1699155093Medicaid
NJ1689054892Medicaid