Healthcare Provider Details

I. General information

NPI: 1992230460
Provider Name (Legal Business Name): GOODWILL CARING HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLYDE RD STE 201
SOMERSET NJ
08873-3493
US

IV. Provider business mailing address

1 CLYDE RD STE 201
SOMERSET NJ
08873-3493
US

V. Phone/Fax

Practice location:
  • Phone: 732-325-1683
  • Fax: 732-325-1239
Mailing address:
  • Phone: 732-325-1683
  • Fax: 732-325-1239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0255500
License Number StateNJ

VIII. Authorized Official

Name: MRS. DORA P GOODWILL
Title or Position: OWNER
Credential: RN
Phone: 908-420-2356