Organization Active NPI

Living New, Real Families Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newark, NJ
National Provider Identifier
1598958340
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
LIVING NEW, REAL FAMILIES INC.
Practice address
15 South 9TH Street
Newark, NJ 07102
Phone
(973) 497-9300
NPI assigned
Aug 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tyshammie Cooper Delisle
Title
Manager
Phone
(973) 509-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NJ Primary

Addresses

Primary practice location

15 South 9TH Street
Newark, NJ 07102

Mailing address

356 Bloomfield Ave
Montclair, NJ 07042-3646
Phone (973) 509-7600

Other identifiers 1

IdentifierTypeStateIssuer
0125059MedicaidNJ

National Provider Directory

National Provider Directory

Locations

356 Bloomfield Ave
Montclair, NJ 07042
Phone (862) 215-6627

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1598958340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 BLOOMFIELD AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423646",
            "telephone_number": "973-509-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SOUTH 9TH STREET",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-497-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING NEW, REAL FAMILIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "DELISLE",
        "authorized_official_first_name": "TYSHAMMIE",
        "authorized_official_middle_name": "COOPER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-509-7600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125059",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.