Organization
SPECIAL HOMES OF NEW JERSEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE MCKEON (EXECUTIVE DIRECTOR)
(973) 886-1953
Entity
Organization
Contact information
Practice address
356 W ENGLEWOOD AVE, ENGLEWOOD, NJ 07631-3239
(973) 886-1953
(976) 664-1795
Mailing address
92 BROADWAY, DENVILLE, NJ 07834-2761
(973) 886-1953
(973) 664-1795
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0530549
—
NJ
Enumeration date
12/03/2017
Last updated
12/03/2017
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