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Broadway Group Home Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lodi, New Jersey
NPI 1154037604

Broadway Group Home Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Fair Lawn, NJ. Broadway Group Home Llc practices in Lodi, NJ. The NPI Number for Broadway Group Home Llc is 1154037604 and holds a License No. (New Jersey).

The current practice location address for Broadway Group Home Llc is 16 Gunther Ave, Lodi, NJ and can be reached out via phone at 973-546-0488.

Location: 16 Gunther Ave, Lodi, NJ, 07410-2055
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1154037604
Provider Name
Broadway Group Home Llc
Credential
Provider Entity Type
Organization
Address
16 Gunther Ave, Lodi, NJ, 07410-2055
Phone Number
973-546-0488
Fax Number
Provider Enumeration Date
01/27/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
16 Gunther Ave
City
Lodi
State
New Jersey
Zip
07644-2015
Phone Number
973-546-0488
Fax Number
person
Provider Business Mailing Address Details
Address
16 Gunther Ave
City
Lodi
State
New Jersey
Zip
07644-2015
Phone Number
973-546-0488
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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