NPIMap

Organization Active NPI

Avidd Community Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Budd Lake, NJ
National Provider Identifier
1831710938
Registry record updated Apr 29, 2020
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
AVIDD COMMUNITY SERVICES
Practice address
74 Village GRN Apt 26G
Budd Lake, NJ 07828-1379
Phone
(973) 664-1770
NPI assigned
Apr 29, 2020
Last updated
Apr 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Authorized official

Name
Terrence McKeon
Title
Executive Director
Phone
(973) 886-1953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

74 Village GRN Apt 26G
Budd Lake, NJ 07828-1379

Mailing address

92 Broadway Ste 101
Denville, NJ 07834-2733
Phone (973) 664-1770

Other identifiers 1

IdentifierTypeStateIssuer
0530549MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Special Homes of New Jersey Inc33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1831710938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 BROADWAY STE 101",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342733",
            "telephone_number": "973-664-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 VILLAGE GRN APT 26G",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078281379",
            "telephone_number": "973-664-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIDD COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "MCKEON",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-886-1953"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0530549",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Budd Lake, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.