Provider Demographics
NPI:1821315078
Name:NEW LIFE HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:NEW LIFE HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
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:BTH
Authorized Official - Phone:609-223-7635
Mailing Address - Street 1:827 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-1411
Mailing Address - Country:US
Mailing Address - Phone:609-458-9969
Mailing Address - Fax:
Practice Address - Street 1:827 E STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1411
Practice Address - Country:US
Practice Address - Phone:609-458-9969
Practice Address - Fax:609-218-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0141100163W00000X, 164W00000X, 364S00000X, 374U00000X
320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical DisabilitiesGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1821315078OtherPHYSICAL THERAPY