Organization
INNOVATIVE LIFE OF NEW JERSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CARRINGTON (PRESIDENT AND CEO)
(301) 602-9997
Entity
Organization
Contact information
Practice address
1900 MOUNT HOLLY RD STE 600A, BURLINGTON, NJ 08016-4722
(301) 270-4750
Mailing address
8484 GEORGIA AVE STE 900, SILVER SPRING, MD 20910-5604
(301) 270-4750
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/15/2019
Last updated
05/02/2023
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