NPIMap

Organization Active NPI

State of New Jersey Omb Centralized Payroll

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Clinton, NJ
National Provider Identifier
1811931504
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
320600000X Issued in NJ
Legal business name
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Practice address
40 Pittstown Rd
Clinton, NJ 08809-1209
Phone
(908) 730-1301
Fax
(908) 730-1339
NPI assigned
Jun 15, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Melissa A Clough
Title
Business Manager
Phone
(908) 730-1301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 320600000X NJ Primary

Addresses

Primary practice location

40 Pittstown Rd
Clinton, NJ 08809-1209

Mailing address

40 Pittstown Road
P.O. Box 4003
Clinton, NJ 08864
Phone (908) 730-1301

Other identifiers 2

IdentifierTypeStateIssuer
4482506MedicaidNJ
528586OtherMEDICARE BILLING GROUP

Other names 1

  • Hunterdon Developmental Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000058 NJ Part B Supplier - Clinic/Group Practice 6406742592 Receives reassigned benefits from 23 practitioners
Practice locations: Clinton, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811931504. Details of each certification follow.

  • CCN 31G001 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 31G001

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HUNTERDON DEVELOPMENTAL CENTER
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 28, 1977
Last certification
Nov 20, 2024
Beds
465
Ownership / control type
State
Facility address
40 Pittstown Rd
Clinton, NJ 08809

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
31D0684567Hunterdon Developmental Center40 Pittstown Road, Clinton, NJ 08809Certificate of waiverAug 24, 2026

National Provider Directory

National Provider Directory
Tax ID family
Hunterdon Development C22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
New Jersey Veterans Memorial Home at ParamusParamus, NJ, CCN 315346 Skilled nursing facility Operational/Managerial Control
Other		 Jul 1, 1995
Jul 1, 1995

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1811931504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PITTSTOWN ROAD",
            "address_2": "P.O. BOX 4003",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "08864",
            "telephone_number": "908-730-1301",
            "fax_number": "908-730-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PITTSTOWN RD",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091209",
            "telephone_number": "908-730-1301",
            "fax_number": "908-730-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "CLOUGH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "908-730-1301"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": "320600000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4482506",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BILLING GROUP",
            "identifier": "528586",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hunterdon Developmental Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clinton, NJ

Sources for this page

Verify at the official NPI Registry.