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General NPI Number Information
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NPI Number | 1376417659
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Entity Type | Organization
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Legal Business Name | GOODLAND TLC HOME HEALTH AGENCY
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 4 SKYLINE DR
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City | HAZLET
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State | NJ
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Zip | 07730-1679
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Country | US
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Telephone | 732-910-2894
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SKYLINE DR
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City | HAZLET
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State | NJ
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Zip | 07730-1679
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Country | US
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Telephone | 732-910-2894
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. OMOBUKOLA ITUA
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Credential | RVT
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Telephone | 732-910-2894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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