NPIMap

Organization Active NPI

Broadstep Academy-New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Beverly, NJ
National Provider Identifier
1437800398
Registry record updated Jan 12, 2022
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
BROADSTEP ACADEMY-NEW JERSEY, INC.
Practice address
1105 Laurel Rd
Beverly, NJ 08010-2608
Phone
(973) 579-3700
NPI assigned
Jan 12, 2022
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Patty Bates
Title
Accounting Manager
Phone
(973) 579-3700

Specialties & licenses 1

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

Addresses

Primary practice location

1105 Laurel Rd
Beverly, NJ 08010-2608

Mailing address

8 Wilson Dr
Sparta, NJ 07871-3400
Phone (973) 579-3700

Other identifiers 1

IdentifierTypeStateIssuer
0479896MedicaidNJ

Other names 1

  • Laurel/Beverly GH DDD Other name

National Provider Directory

National Provider Directory
Tax ID family
Willowglen Academy - New Jersey Inc60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1437800398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WILSON DR",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713400",
            "telephone_number": "973-579-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 LAUREL RD",
            "city": "BEVERLY",
            "state": "NJ",
            "postal_code": "080102608",
            "telephone_number": "973-579-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADSTEP ACADEMY-NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "973-579-3700"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0479896",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel/Beverly GH DDD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beverly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.