NPIMap

Organization Active NPI

Beacon Specialized Living New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Willingboro, NJ
National Provider Identifier
1851142095
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
BEACON SPECIALIZED LIVING NEW JERSEY, INC.
Practice address
25 Babcock LN
Willingboro, NJ 08046-1603
Phone
(609) 987-5003
NPI assigned
Mar 27, 2024
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Darren Hodgdon
Title
Ceo
Phone
(269) 427-8400

Specialties & licenses 1

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

Addresses

Primary practice location

25 Babcock LN
Willingboro, NJ 08046-1603

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0943631MedicaidNJ

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1851142095",
    "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": "25 BABCOCK LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461603",
            "telephone_number": "609-987-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON SPECIALIZED LIVING NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "HODGDON",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "269-427-8400"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0943631",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.