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INNOVATIVE LIFE OF NEW JERSEY
NPI 1316614092
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Willingboro, NJ

Active since August 30, 2021
88 CLUB HOUSE DR, WILLINGBORO, NJ 08046(301) 270-4750 Get Directions Write a Review

NPPES record last updated: August 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Innovative Life Of New Jersey NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVATIVE LIFE OF NEW JERSEY (NPI 1316614092) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Willingboro, New Jersey and active in the NPI registry since August 2021. The organization lists Shinavia Mckinney, Coo, as its authorized official.

NPPES Registry Identity

NPI1316614092
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameINNOVATIVE LIFE OF NEW JERSEY
Location Address88 CLUB HOUSE DRWillingboro, NJ 08046-3404
Mailing Address8484 Georgia Ave Ste 900Silver Spring, MD 20910-5604 · (301) 270-4750
Phone(301) 270-4750
Organization SubpartNo
Authorized OfficialShinavia MckinneyCoo · (301) 270-4750
Enumeration DateAugust 30, 2021
NPPES CertifiedAugust 10, 2021
✔ NPI 1316614092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
88 CLUB HOUSE DR, Willingboro, NJ 08046
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovative Life Of New Jersey's NPI number?

The NPI number for Innovative Life Of New Jersey is 1316614092. It was assigned to this organization in the NPPES registry on August 30, 2021.

Where is Innovative Life Of New Jersey located?

Innovative Life Of New Jersey is located at 88 Club House Dr, Willingboro, NJ 08046. The listed phone number is (301) 270-4750.

What is Innovative Life Of New Jersey's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Innovative Life Of New Jersey was last updated on August 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.