NPIMap

Organization Active NPI

Special Needs Residence LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Warren, NJ
National Provider Identifier
1811399702
Registry record updated Jun 20, 2016
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
Warren, NJ 07059-5129
Phone
(908) 757-7000
Fax
(908) 757-7022
NPI assigned
Sep 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Ms. Deena Schaffer
Title
Member
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
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

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
Warren, NJ 07059
Phone (732) 463-0923

Ownership & related parties

Subparts reporting this organization as parent 23

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1811399702",
    "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",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595129",
            "telephone_number": "908-757-7000",
            "fax_number": "908-757-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL NEEDS RESIDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "DEENA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "908-889-4200",
        "authorized_official_name_prefix": "Ms."
    },
    "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 Jun 20, 2016; 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.