Broadway Group Home LLC
NPI #1154037604 in Lodi, New Jersey
Provider Information
- NPI Number
- 1154037604
- Entity Type
- Organization
- Organization Name
- Broadway Group Home LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jan 27, 2023
- Last Updated
- Jan 27, 2023
Practice Location
- Address
- 16 GUNTHER AVE
- City
- Lodi
- State
- New Jersey
- ZIP Code
- 07644-2015
- Phone
- (973) 546-0488
Authorized Official
- Name
- PATRICK PATTON
- Title
- COO
- Phone
- (973) 546-0488
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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