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Beacon Specialized Living New Jersey, Inc.

Organization Active NPI In Home Supportive Care Agency · Ewing, NJ

NPI 1104525831 · NPPES record last updated Mar 6, 2023

Key facts

NPI
1104525831
Entity type
Organization (NPI type 2)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Legal business name
BEACON SPECIALIZED LIVING NEW JERSEY, INC.
Practice address
1015 Whitehead Road Ext Apt 124
Ewing, NJ 08638-2433
Phone
(609) 987-5003
NPI assigned
Mar 2, 2023
Organization subpart
No

Authorized official

Name
Darren Hodgdon
Title
Chief Executive Officer
Phone
(269) 427-8400

Corporate family (same tax ID) 17

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

National Provider Directory

Tax ID family
Beacon Specialized Living New Jersey Inc (61 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

1015 Whitehead Road Ext Apt 124
Ewing, NJ 08638-2433

Mailing address

13 Roszel Rd Ste B110
Princeton, NJ 08540-6211
Phone (609) 987-5003

Other identifiers

IdentifierTypeStateIssuer
0450858187MedicaidNJ

Other providers in Ewing, NJ

All providers in Ewing, NJ · In Home Supportive Care Agency in New Jersey

Sources for this page

Verify at the official NPI Registry.