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General NPI Number Information
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NPI Number | 1497692156
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Entity Type | Organization
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Legal Business Name | GRANDULAR HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 146 S LAKEVIEW DR STE 202
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City | GIBBSBORO
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State | NJ
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Zip | 08026-1018
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Country | US
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Telephone | 609-669-0097
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Fax | 856-875-9608
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Provider Business Mailing Address
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Address Line | 146 S LAKEVIEW DR STE 202
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City | GIBBSBORO
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State | NJ
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Zip | 08026-1018
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Country | US
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Telephone | 609-669-0097
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Fax | 856-875-9608
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Authorized Official
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Title or Position | CEO
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Name | DEBORAH DICKERSON
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Credential |
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Telephone | 609-669-0097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0005X
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Taxonomy Name | Neurodevelopmental Disabilities Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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