Healthcare Provider Details

I. General information

NPI: 1780704056
Provider Name (Legal Business Name): AGC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 PRESIDENT ST
SADDLE BROOK NJ
07663-6323
US

IV. Provider business mailing address

338 PRESIDENT ST
SADDLE BROOK NJ
07663-6323
US

V. Phone/Fax

Practice location:
  • Phone: 973-928-3428
  • Fax:
Mailing address:
  • Phone: 973-928-3428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number35SI00033100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number35SI00033100
License Number StateNJ

VIII. Authorized Official

Name: ROBERT MCGOWAN
Title or Position: DIRECTOR
Credential:
Phone: 973-928-3428