Organization
SPECIAL HOMES OF NEW JERSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE MCKEON M.ED. (EXECUTIVE DIRECTOR)
(973) 886-1953
Entity
Organization
Contact information
Practice address
74 VILLAGE GRN APT 10D, BUDD LAKE, NJ 07828-1379
(973) 886-1953
(973) 664-1795
Mailing address
74 VILLAGE GRN APT 14R, BUDD LAKE, NJ 07828-1379
(973) 886-1953
(973) 664-1795
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0530549
—
NJ
Enumeration date
10/07/2016
Last updated
04/10/2018
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