# BEACON SPECIALIZED LIVING NEW JERSEY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245930858
- **Authorized official:** DARREN HODGDON (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (269) 427-8400

## Contact information

- **Practice address:** 22 LEBED DR, SOMERSET, NJ 08873-2932
- **Practice address phone:** (732) 296-0304
- **Mailing address:** 13 ROSZEL RD STE B110, PRINCETON, NJ 08540-6211
- **Mailing address phone:** (609) 987-5003
- **Mailing address fax:** (609) 520-7979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/03/2023
- **Last updated:** 03/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0450858187 | — | NJ |