OrganizationActive
Broadway Group Home LLC
NPI 1154037604 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Lodi, NJ
Provider details
- NPI number
- 1154037604
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Patrick Patton, Coo(973) 546-0488
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
16 Gunther Ave
Lodi, NJ 07644-2015
Phone: (973) 546-0488
Street-level locationGet directions
Mailing address
17-17 Broadway
Fair Lawn, NJ 07410-2055
Registry dates
- Enumerated
- 2023-01-27
- Last updated
- 2023-01-27
- Certified
- 2023-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.