Organization · NPI-2

Beacon Specialized Living New Jersey, INC.

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

NPI number1770286304
StatusActive
Last updated in NPPESMar 23, 2023

Details

NPI
1770286304
Entity type
Organization (NPI-2)
Legal business name
Beacon Specialized Living New Jersey, INC.
Organization subpart
No
Enumeration date
Mar 23, 2023
Certification date
Mar 1, 2023
Last updated
Mar 23, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities––Yes

Practice location

425 Drum Point Rd
Brick, NJ 08723-6833

Phone 732-477-1374

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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