Organization · Type 2 NPI

Broadway Group Home LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Lodi, NJ

NPI number 1154037604 Active

Practice location

16 Gunther Ave
Lodi, NJ 07644-2015

Call (973) 546-0488 Map

Mailing address

17-17 Broadway
Fair Lawn, NJ 07410-2055

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1154037604

Broadway Group Home LLC's National Provider Identifier is 1154037604, issued on Jan 27, 2023. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Lodi, NJ. The record was last updated on Jan 27, 2023.