NPIMap

Organization Active NPI

Special Needs Residence LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Warren, NJ
National Provider Identifier
1376179689
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
SPECIAL NEEDS RESIDENCE LLC
Practice address
130 Mount Bethel Rd Apt 215
Warren, NJ 07059-5129
Phone
(908) 757-7000
NPI assigned
Mar 18, 2020
Organization subpart
Yes
Parent organization
SPECIAL NEEDS RESIDENCE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Authorized official

Name
Deena Schaffer
Title
Cfo
Phone
(908) 889-4200

Specialties & licenses 1

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

Addresses

Primary practice location

130 Mount Bethel Rd Apt 215
Warren, NJ 07059-5129

Mailing address

316 South Ave
Fanwood, NJ 07023-1325
Phone (908) 889-4200

Other names 1

  • Mt Bethel Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Special Needs Residence24 organizations share this tax ID, including this one
Part of
Special Needs Residence

Other organizations with this tax ID 23

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

View all 23

Locations

130 Mount Bethel Rd
Apt 215
Warren, NJ 07059
Phone (908) 757-7000

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1376179689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 SOUTH AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231325",
            "telephone_number": "908-889-4200",
            "fax_number": "908-889-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MOUNT BETHEL RD APT 215",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595129",
            "telephone_number": "908-757-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL NEEDS RESIDENCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIAL NEEDS RESIDENCE LLC",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "DEENA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "908-889-4200"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt Bethel Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.