Innovative Life of New Jersey
NPI #1316614092 in Willingboro, New Jersey
Provider Information
- NPI Number
- 1316614092
- Entity Type
- Organization
- Organization Name
- Innovative Life of New Jersey
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Aug 30, 2021
- Last Updated
- Aug 30, 2021
Practice Location
- Address
- 88 CLUB HOUSE DR
- City
- Willingboro
- State
- New Jersey
- ZIP Code
- 08046-3404
- Phone
- (301) 270-4750
Authorized Official
- Name
- SHINAVIA MCKINNEY
- Title
- COO
- Phone
- (301) 270-4750
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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