MT BETHEL VILLAGE
NPI 1063927507
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Warren, NJ
About Mt Bethel Village NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MT BETHEL VILLAGE (NPI 1063927507) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Warren, New Jersey and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through September 9, 2027 and lists Deena Schaffer, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 31D2235590
Special Needs Residence LLC Dba Mt Bethel Village · Warren, NJFrequently 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 Special Needs Residence LLC's NPI number?
The NPI number for Special Needs Residence LLC is 1063927507. It was assigned to this organization in the NPPES registry on December 6, 2017. The provider is doing business as Mt Bethel Village.
Where is Special Needs Residence LLC located?
Special Needs Residence LLC is located at 130 Mount Bethel Rd Apt 201, Warren, NJ 07059. The listed phone number is (908) 757-7000.
What is Special Needs Residence LLC's specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.
Does Special Needs Residence LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 31D2235590) is associated with this NPI, valid through September 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Special Needs Residence LLC was last updated on December 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Mt Bethel Village · NPI 1063927507
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities organization in Warren, New Jersey. Organization record, active in the CMS NPPES registry since December 6, 2017.
## Identity
- **NPI:** 1063927507 (Entity type: Organization)
- **Enumerated:** December 6, 2017
- **Primary specialty:** Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · taxonomy 320900000X
- **Legal business name:** Special Needs Residence Llc
- **Organization subpart:** Yes (part of Special Needs Residence Llc)
- **Authorized official:** Deena Schaffer, CFO
## Practice location
- **Address:** 130 MOUNT BETHEL RD APT 201, Warren, NJ 07059-5129
- **Phone:** (908) 757-7000
## Record status
- **NPPES last updated:** December 6, 2017
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063927507) · Data from the CMS NPPES public registry.