Organization
BEACON SPECIALIZED LIVING NEW JERSEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN HODGDON (CHIEF EXECUTIVE OFFICER)
(269) 427-8400
Entity
Organization
Contact information
Practice address
53 POND LN, WILLINGBORO, NJ 08046-2756
(609) 987-5003
Mailing address
13 ROSZEL RD STE B110, PRINCETON, NJ 08540-6211
(609) 987-5003
(609) 520-7979
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0943631
—
NJ
Enumeration date
03/27/2024
Last updated
03/27/2024
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