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Spectrum for Living Development, Inc.

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · River Vale, NJ

NPI 1013439702 · NPPES record last updated Feb 28, 2020

Key facts

NPI
1013439702
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
SA555 (NJ)
Legal business name
SPECTRUM FOR LIVING DEVELOPMENT, INC.
Practice address
81 Rivervale Rd Apt 2-1C
River Vale, NJ 07675-6285
Phone
(201) 722-0904
NPI assigned
Jul 13, 2017
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 16

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Spectrum for Living Development Inc (75 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X SA555 NJ Yes

Addresses

Primary practice location

81 Rivervale Rd Apt 2-1C
River Vale, NJ 07675-6285

Mailing address

210 Rivervale Rd Apt 3
River Vale, NJ 07675-6281
Phone (201) 358-8000

Other identifiers

IdentifierTypeStateIssuer
0536521MedicaidNJ

Other providers in River Vale, NJ

All providers in River Vale, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.