Healthcare Provider Details

I. General information

NPI: 1629902358
Provider Name (Legal Business Name): NURTURED NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 JEFFERSON BLVD
EDISON NJ
08817-3539
US

IV. Provider business mailing address

PO BOX 8111
PISCATAWAY NJ
08855-8008
US

V. Phone/Fax

Practice location:
  • Phone: 732-336-0338
  • Fax:
Mailing address:
  • Phone: 732-336-1908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMIRAH GOODE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 732-336-0338