Provider Demographics
NPI:1982674917
Name:NEW DIMENSIONS IN LIVING INC
Entity Type:Organization
Organization Name:NEW DIMENSIONS IN LIVING INC
Other - Org Name:NEW DIMENSIONS IN HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-954-3213
Mailing Address - Street 1:40 WALL ST
Mailing Address - Street 2:NEW DIMENSIONS IN HEALTH CARE
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:518-843-2575
Mailing Address - Fax:518-843-3255
Practice Address - Street 1:40 WALL ST
Practice Address - Street 2:NEW DIMENSIONS IN HEALTH CARE
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-843-2575
Practice Address - Fax:518-843-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01667138Medicaid
56026AMedicare ID - Type Unspecified