Healthcare Provider Details

I. General information

NPI: 1568375509
Provider Name (Legal Business Name): THE GOOD SAMARITAN HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ALDINE ST APT 1
NEWARK NJ
07112-1551
US

IV. Provider business mailing address

105 ALDINE ST APT 1
NEWARK NJ
07112-1551
US

V. Phone/Fax

Practice location:
  • Phone: 973-651-7503
  • Fax:
Mailing address:
  • Phone: 973-651-7503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: FABIOLA VINCENT
Title or Position: GENERAL MANAGER
Credential: CNA
Phone: 973-651-7503