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BEACON SPECIALIZED LIVING NEW JERSEY, INC.
NPI 1013615269
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Kalamazoo, MI

Active since February 17, 2023
890 N 10TH ST, KALAMAZOO, MI 49009(269) 427-8400 Get Directions Write a Review

NPPES record last updated: March 2, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 2, 2023, Feb 24, 2023, Feb 17, 2023 (3 updates tracked since 2023).

About Beacon Specialized Living New Jersey, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACON SPECIALIZED LIVING NEW JERSEY, INC. (NPI 1013615269) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Kalamazoo, Michigan and active in the NPI registry since February 2023. The organization lists Darren Hodgdon, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1013615269
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameBEACON SPECIALIZED LIVING NEW JERSEY, INC.
Location Address890 N 10TH STKalamazoo, MI 49009-6192
Mailing Address890 N 10th StKalamazoo, MI 49009-6192 · (269) 427-8400
Phone(269) 427-8400
Organization SubpartNo
Authorized OfficialDarren HodgdonChief Executive Officer · (269) 427-8400
Enumeration DateFebruary 17, 2023
Last NPPES UpdateMarch 2, 20233 updates tracked since enumeration
NPPES CertifiedMarch 2, 2023
✔ NPI 1013615269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
890 N 10TH ST, Kalamazoo, MI 49009
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Other Identifiers 1

Medicaid0450858187MI

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CORI ELLE RAMGREN LPN
Licensed Practical Nurse
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (440) 320-3909
AMIE LYNN ZAPF LPN
Licensed Practical Nurse
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (269) 365-3017
MOLLY SIMON RN
Registered Nurse
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (888) 527-0012
BRIANA WIEL
Licensed Practical Nurse
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (888) 527-0012
MS. KATRYCE RENAE BROWN LMSW
Social Worker (Clinical)
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (269) 370-6848
MS. WENDY RANEE BLANTON LPN
Licensed Practical Nurse
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (888) 527-0012
KARLA MARIE AVERILL MA,LLP
Psychologist
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (269) 427-8400
MR. GERARD REMILLARD III
Licensed Practical Nurse
890 N 10TH ST
KALAMAZOO, MI 49009
Kalamazoo County (248) 460-3434

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beacon Specialized Living New Jersey, Inc.'s NPI number?

The NPI number for Beacon Specialized Living New Jersey, Inc. is 1013615269. It was assigned to this organization in the NPPES registry on February 17, 2023.

Where is Beacon Specialized Living New Jersey, Inc. located?

Beacon Specialized Living New Jersey, Inc. is located at 890 N 10th St, Kalamazoo, MI 49009. The listed phone number is (269) 427-8400.

What is Beacon Specialized Living New Jersey, Inc.'s specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Beacon Specialized Living New Jersey, Inc. was last updated on March 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.