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Beacon Specialized Living New Jersey

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Brick, NJ

NPI 1134828940 · NPPES record last updated Mar 2, 2023

Key facts

NPI
1134828940
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
Practice address
425 Drum Point Rd
Brick, NJ 08723-6833
Phone
(732) 477-1374
NPI assigned
Mar 1, 2023
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 18

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
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

425 Drum Point Rd
Brick, NJ 08723-6833

Mailing address

13 Roszel Rd Ste B110
Princeton, NJ 08540-6211
Phone (609) 798-7350

Other identifiers

IdentifierTypeStateIssuer
0450858187MedicaidNJ

Other providers in Brick, NJ

All providers in Brick, NJ · Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.