NPIMap

Organization Active NPI

Spectrum for Living Development, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Edison, NJ
National Provider Identifier
1003338849
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
SA546 Issued in NJ
Legal business name
SPECTRUM FOR LIVING DEVELOPMENT, INC.
Practice address
1313 Waterford Dr
Edison, NJ 08817-1928
Phone
(732) 650-0696
NPI assigned
Jul 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Authorized official

Name
William G. Muilenburg
Title
Cfo
Phone
(201) 358-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X SA546 NJ Primary

Addresses

Primary practice location

1313 Waterford Dr
Edison, NJ 08817-1928

Mailing address

210 Rivervale Rd
River Vale, NJ 07675-6281
Phone (201) 358-8000

Other identifiers 1

IdentifierTypeStateIssuer
0536521MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Spectrum for Living Development Inc75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1003338849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 RIVERVALE RD",
            "city": "RIVER VALE",
            "state": "NJ",
            "postal_code": "076756281",
            "telephone_number": "201-358-8000",
            "fax_number": "201-358-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 WATERFORD DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088171928",
            "telephone_number": "732-650-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM FOR LIVING DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "MUILENBURG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "201-358-8000"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "SA546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0536521",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.