Organization
BROADWAY GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK PATTON (COO)
(973) 546-0488
Entity
Organization
Contact information
Practice address
36-05 BROADWAY, FAIR LAWN, NJ 07410-4644
(973) 546-0488
Mailing address
17-17 BROADWAY, FAIR LAWN, NJ 07410-2055
(201) 703-3980
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
02/02/2023
Last updated
02/04/2023
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