Healthcare Provider Details

I. General information

NPI: 1639910284
Provider Name (Legal Business Name): EMDAZZ GOALS OF HOME HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 ROUTE 88
BRICK NJ
08724-3010
US

IV. Provider business mailing address

1617 ROUTE 88 STE 205
BRICK NJ
08724-3010
US

V. Phone/Fax

Practice location:
  • Phone: 609-906-1179
  • Fax:
Mailing address:
  • Phone: 609-906-1179
  • Fax: 732-860-9994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAZZLYN MAAME-GYAMFUA
Title or Position: PRESIDENT
Credential: DON
Phone: 973-641-5363