NPIMap

Organization Active NPI

Beacon Specialized Living New Jersey, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Ewing, NJ
National Provider Identifier
1851090583
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
BEACON SPECIALIZED LIVING NEW JERSEY, INC.
Practice address
370 Sullivan Way
Ewing, NJ 08628-3411
Phone
(609) 987-5003
NPI assigned
Mar 2, 2023
Last updated
Mar 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Darren Hodgdon
Title
Chief Executive Officer
Phone
(269) 427-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

370 Sullivan Way
Ewing, NJ 08628-3411

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0450858187MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Beacon Specialized Living New Jersey Inc61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1851090583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ROSZEL RD STE B110",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406211",
            "telephone_number": "609-987-5003",
            "fax_number": "609-520-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 SULLIVAN WAY",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283411",
            "telephone_number": "609-987-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON SPECIALIZED LIVING NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "HODGDON",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "269-427-8400"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450858187",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.