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Beacon Specialized Living New Jersey, Inc.

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

NPI 1649979477 · NPPES record last updated Mar 2, 2023

Key facts

NPI
1649979477
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, INC.
Practice address
58 Rose CT
Eatontown, NJ 07724-1516
Phone
(732) 389-2607
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) 24

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

58 Rose CT
Eatontown, NJ 07724-1516

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
0450858187MedicaidNJ

Other providers in Eatontown, NJ

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

Sources for this page

Verify at the official NPI Registry.