NPIMap

Organization Active NPI

Broadway Group Home LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Wayne, NJ
National Provider Identifier
1992401830
Registry record updated Feb 2, 2023
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
BROADWAY GROUP HOME LLC
Practice address
1480 Ratzer Rd
Wayne, NJ 07470-2430
Phone
(973) 546-0488
NPI assigned
Feb 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Patrick Patton
Title
Coo
Phone
(973) 546-0488

Specialties & licenses 1

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

Addresses

Primary practice location

1480 Ratzer Rd
Wayne, NJ 07470-2430

Mailing address

17-17 Broadway
Fair Lawn, NJ 07410-2055
Phone (201) 703-3980

National Provider Directory

National Provider Directory
Tax ID family
Broadway Group Home LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1992401830",
    "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": "074102055",
            "telephone_number": "201-703-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 RATZER RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702430",
            "telephone_number": "973-546-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "973-546-0488"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

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