Special Needs Residence LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Warren, NJ. Organization (NPI-2).
NPI number1164052197
StatusActive
Last updated in NPPESJan 17, 2020
Details
- NPI
- 1164052197
- Entity type
- Organization (NPI-2)
- Legal business name
- Special Needs Residence LLC
- Organization subpart
- Yes
- Enumeration date
- Jan 17, 2020
- Certification date
- Jan 17, 2020
- Last updated
- Jan 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Other names
- Mt Bethel Village (Doing Business As)
Practice location
130 Mount Bethel Rd Apt 105Warren, NJ 07059-5129
Phone 908-757-7000
Mailing address
316 South AveFanwood, NJ 07023-1325
Phone 908-889-4200 · Fax 908-889-4224
Authorized official
Deena Schaffer
Cfo
9088894200
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All 28 Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility providers in Warren · All 572 providers in Warren
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