Beacon Specialized Living New Jersey, Inc.
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Manalapan, NJ
NPI 1003519638 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1003519638
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- Legal business name
- BEACON SPECIALIZED LIVING NEW JERSEY, INC.
- Practice address
- Forge at Manalapan Crossing
400 Crossing Lane, Apartment 310
Manalapan, NJ 07726 - Phone
- (732) 677-1165
- NPI assigned
- Mar 23, 2023
- Organization subpart
- No
Authorized official
- Name
- Darren Hodgdon
- Title
- Chief Executive Officer
- Phone
- (269) 427-8400
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Beacon Specialized Living New Jersey Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | Yes |
Addresses
Primary practice location
Forge at Manalapan Crossing
400 Crossing Lane, Apartment 310
Manalapan, NJ 07726
Mailing address
13 Roszel Rd Ste B110
Princeton, NJ 08540-6211
Phone (609) 987-5003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0450858187 | Medicaid | NJ |
Other providers in Manalapan, NJ
- Moira Colleen Barocas
- Diane A Barravecchio
- Alan L. Bass
- Paul J Battipaglia
- Nicole Bavaro Zukofski
- Beacon Specialized Living New Jersey, Inc.
- Beacon Specialized Living New Jersey, Inc.
- Beacon Specialized Living New Jersey, Inc.
- Beacon Specialized Living New Jersey, Inc.
- Beacon Specialized Living New Jersey, Inc.
All providers in Manalapan, NJ · Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.