Healthcare Provider Details

I. General information

NPI: 1497557862
Provider Name (Legal Business Name): GARDEN STATE BEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 PEARL ST
NEWFIELD NJ
08344-2604
US

IV. Provider business mailing address

5025 GERMANTOWN AVE
PHILADELPHIA PA
19144-5963
US

V. Phone/Fax

Practice location:
  • Phone: 267-581-3923
  • Fax:
Mailing address:
  • Phone: 215-644-8341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY PAGE
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 267-581-3923