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General NPI Number Information
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NPI Number | 1639835754
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Entity Type | Organization
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Legal Business Name | GODDARD ESSENTIAL CARE LLC
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 199 ATLANTIC AVE
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City | TRENTON
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State | NJ
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Zip | 08609-1705
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Country | US
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Telephone | 609-610-0542
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Fax |
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Provider Business Mailing Address
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Address Line | 4 QUINCY MANOR LN
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City | BURLINGTON
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State | NJ
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Zip | 08016-5116
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Country | US
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Telephone | 609-516-6249
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ALBERT S GIPLE
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Credential |
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Telephone | 609-516-6249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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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 | 385H00000X
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Taxonomy Name | Respite Care
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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