NPIMap

Organization Active NPI

Beacon Specialized Living New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Manalapan, NJ
National Provider Identifier
1912600545
Registry record updated Mar 23, 2023
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
162 Highway 33
Apartment 5
Manalapan, NJ 07726
Phone
(609) 987-5003
NPI assigned
Mar 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 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
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

162 Highway 33
Apartment 5
Manalapan, NJ 07726

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1912600545",
    "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": "162 HIGHWAY 33",
            "address_2": "APARTMENT 5",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "07726",
            "telephone_number": "609-987-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON SPECIALIZED LIVING NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "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": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0450858187",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.