Organization · NPI-2

Beacon Specialized Living New Jersey, INC.

Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Brick, NJ

NPI number1295434967

StatusActive

Last updated in NPPESMar 2, 2023

Details

NPI: 1295434967
Entity type: Organization (NPI-2)
Legal business name: Beacon Specialized Living New Jersey, INC.
Organization subpart: No
Enumeration date: Mar 1, 2023
Certification date: Mar 2, 2023
Last updated: Mar 2, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–	Yes

Practice location

481 Herbertsville Rd
Brick, NJ 08724

Phone 732-458-0240

Mailing address

13 Roszel Rd Ste B110
Princeton, NJ 08540-6211

Phone 609-987-5003 · Fax 609-520-7979

Authorized official

Darren Hodgdon
Chief Executive Officer
2694278400

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