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INNOVATIVE LIFE OF NEW JERSEY
NPI 1871176826
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Eatontown, NJ

Active since April 28, 2021
158A EATONCREST DR, EATONTOWN, NJ 07724(609) 526-3900 Get Directions Write a Review

NPPES record last updated: April 28, 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 1871176826) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Eatontown, New Jersey and active in the NPI registry since April 2021. The organization lists Shinavia Mckinney, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1871176826
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameINNOVATIVE LIFE OF NEW JERSEY
Location Address158A EATONCREST DREatontown, NJ 07724-1261
Mailing Address1900 Mount Holly Rd Ste 600aBurlington, NJ 08016-4722 · (609) 526-3900 · Fax (301) 264-1154
Phone(609) 526-3900
Organization SubpartNo
Authorized OfficialShinavia MckinneyExecutive Director · (301) 270-4750
Enumeration DateApril 28, 2021
NPPES CertifiedApril 28, 2021
✔ NPI 1871176826 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.
158A EATONCREST DR, Eatontown, NJ 07724
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Other Identifiers 1

Medicaid0726524NJ

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SERV ACHIEVEMENT CENTERS, INC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
158A EATONCREST DR
EATONTOWN, NJ 07724
Monmouth County (609) 406-0100
ALTERNATIVES, INC.
Community/Behavioral Health
158A EATONCREST DR
EATONTOWN, NJ 07724
Monmouth County (908) 685-1444

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 1871176826. It was assigned to this organization in the NPPES registry on April 28, 2021.

Where is Innovative Life Of New Jersey located?

Innovative Life Of New Jersey is located at 158A Eatoncrest Dr, Eatontown, NJ 07724. The listed phone number is (609) 526-3900.

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 April 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.