Provider Demographics
NPI:1275977696
Name:NEW BEGINNINGS AT JOEYS PLACE, LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS AT JOEYS PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DITARANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-525-6649
Mailing Address - Street 1:5310 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7454
Mailing Address - Country:US
Mailing Address - Phone:848-525-6649
Mailing Address - Fax:
Practice Address - Street 1:5310 AUTUMN DR
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7454
Practice Address - Country:US
Practice Address - Phone:848-525-6649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
305R00000X305R00000X
385H00000X385H00000X
385HR2050X385HR2060X
385HR2060X385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child