SPECIAL NEEDS RESIDENCE LLC (NPI# 1760093637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760093637 |
| Entity Type | Organization |
| Organization Name | SPECIAL NEEDS RESIDENCE LLC |
| Practice Address |
130 Mount Bethel Rd Apt 109 Warren NJ 07059-5129 |
| Mailing Address |
316 South Ave Fanwood NJ 07023-1325 |
| Practice Telephone | 9087577000 |
| Mailing Telephone | 9088894200 |
| Mailing Fax Number | 9088894224 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | DEENA SCHAFFER (CFO) |
| Authorized Official Telephone | 9088894200 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPECIAL NEEDS RESIDENCE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Mt Bethel Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593892 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 206, Warren, NJ 07059-5129 | 2020-09-23 |
| 1164033049 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 203, Warren, NJ 07059-5129 | 2020-08-13 |
| 1285260596 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 107, Warren, NJ 07059-5129 | 2020-03-18 |
| 1356977664 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 205, Warren, NJ 07059-5129 | 2020-03-18 |
| 1376179689 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 215, Warren, NJ 07059-5129 | 2020-03-18 |
| 1447886759 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 222, Warren, NJ 07059-5129 | 2020-03-18 |
| 1164052197 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 105, Warren, NJ 07059-5129 | 2020-01-17 |
| 1437795283 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 202, Warren, NJ 07059-5129 | 2019-11-26 |
| 1346886199 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 204, Warren, NJ 07059-5129 | 2019-11-26 |
| 1689210429 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 209, Warren, NJ 07059-5129 | 2019-11-26 |
| Street Address |
130 MOUNT BETHEL RD APT 109 |
| City | WARREN |
| State | NJ |
| Zip Code | 07059-5129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245680826 | Brightview Warren, LLC | Alzheimer Center (Dementia Center) | 55 Mt. Bethel Road, Warren, NJ 07059 | 2016-06-15 |
| 1245617786 | Mt Bethel Day Program LLC | Clinic/Center | 67 Mountain Blvd, Suite 201, Warren, NJ 07059 | 2015-05-05 |
| 1831509413 | Chandana Pande | Internal Medicine | 34 Moutain Blvd, Warren, NJ 07059 | 2014-05-05 |
| 1740624121 | Prakhar Mehrotra | Dentist | 58 Mount Bethel Rd Ste 202, Warren, NJ 07059 | 2013-04-29 |
| 1558680231 | International Healthcare of Nj | Specialist | 3 Tiffanys Way, Warren, NJ 07059 | 2010-05-20 |
| 1740430495 | Danielle Lynnette Neumann | Physical Therapist | 247 King George Rd, Warren, NJ 07059 | 2008-09-30 |
| 1831358381 | Linda Zhang | Ophthalmology | 65 Mountain Blvd. Ext, Ste. 105, Warren, NJ 07059 | 2008-06-09 |
| 1356515597 | Tiffany Lynn Scott | Pediatrics | 76 Stirling Rd., Suite 201, Warren, NJ 07059 | 2008-04-18 |
| 1710011283 | Vincent Frederick Colon | Psychiatry & Neurology | 161 Washington Valley Road, Suite #206, Warren, NJ 07059 | 2007-03-15 |
| 1972666089 | Kwei Ping Shen Kwei | Dentist | 108 Mt Bethel Rd, Warren, NJ 07059 | 2006-12-19 |
| Find all providers in zip 07059 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593892 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 206, Warren, NJ 07059-5129 | 2020-09-23 |
| 1164033049 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 203, Warren, NJ 07059-5129 | 2020-08-13 |
| 1285260596 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 107, Warren, NJ 07059-5129 | 2020-03-18 |
| 1356977664 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 205, Warren, NJ 07059-5129 | 2020-03-18 |
| 1376179689 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 215, Warren, NJ 07059-5129 | 2020-03-18 |
| 1447886759 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 222, Warren, NJ 07059-5129 | 2020-03-18 |
| 1164052197 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 105, Warren, NJ 07059-5129 | 2020-01-17 |
| 1982234910 | Special Needs Residence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 220, Warren, NJ 07059-5129 | 2020-01-17 |
| 1437795283 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 202, Warren, NJ 07059-5129 | 2019-11-26 |
| 1346886199 | Special Needs Residence LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 130 Mount Bethel Rd Apt 204, Warren, NJ 07059-5129 | 2019-11-26 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.