Organization Active NPI

Beachway New Jersey LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lawrenceville, NJ
National Provider Identifier
1649972472
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BEACHWAY NEW JERSEY LLC
Practice address
4 Princess Rd Ste 208
Lawrenceville, NJ 08648-2322
Phone
(772) 812-9652
Fax
(833) 535-0164
NPI assigned
Mar 17, 2023
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Jared Turner
Title
Billing Manager
Phone
(772) 812-9652

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Adult Mental Health Clinic/Center 261QM0850X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

4 Princess Rd Ste 208
Lawrenceville, NJ 08648-2322

Mailing address

1700 N Dixie Hwy
West Palm Beach, FL 33407-6504
Phone (772) 812-9652

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2289403Beachway New Jersey LLC4 Princess Road, Suite 208, Lawrenceville, NJ 08648Certificate of waiverSep 10, 2027

National Provider Directory

National Provider Directory

Locations

4 Princess Rd
Lawrenceville, NJ 08648
Phone (609) 462-9531

4 Princess Rd
Ste 208
Lawrenceville, NJ 08648
Phone (609) 468-7922

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1649972472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334076504",
            "telephone_number": "772-812-9652",
            "fax_number": "833-535-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PRINCESS RD STE 208",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482322",
            "telephone_number": "772-812-9652",
            "fax_number": "833-535-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHWAY NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "772-812-9652"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.