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
74 VILLAGE GRN APT R, BUDD LAKE, NJ 07828-1379
(973) 886-1953
Mailing address
74 VILLAGE GREEN, BUILDING 4 APARTMENT R, BUDD LAKE, NJ 07828-1379
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163950000796
—
NJ
Enumeration date
08/29/2017
Last updated
06/16/2018
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