NPIMap

Organization Active NPI

Broadway Respite and Home Care, LLC

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • North Brunswick, NJ
National Provider Identifier
1831617026
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
Legal business name
BROADWAY RESPITE AND HOME CARE, LLC
Practice address
1007 Livingston Ave
North Brunswick, NJ 08902
Phone
(201) 703-3980
Fax
(201) 703-3984
NPI assigned
Sep 7, 2017
Last updated
Mar 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Authorized official

Name
Anastasia Vaynberg
Title
Billing Manager
Phone
(201) 703-3980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X Primary

Addresses

Primary practice location

1007 Livingston Ave
North Brunswick, NJ 08902

Mailing address

17-17 Broadway
Fair Lawn, NJ 07410
Phone (201) 703-3980

Other identifiers 1

IdentifierTypeStateIssuer
0519049MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Broadway Respite and Home Care17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1831617026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17-17 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-703-3980",
            "fax_number": "201-703-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LIVINGSTON AVE",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "08902",
            "telephone_number": "201-703-3980",
            "fax_number": "201-703-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY RESPITE AND HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-07",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "VAYNBERG",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "201-703-3980"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0519049",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.