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General NPI Number Information
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NPI Number | 1891628103
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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 | 06/05/2026
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Last Update Date | 06/05/2026
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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 |
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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 | MRS. 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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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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 | 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 #3
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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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 | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 282NW0100X
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Taxonomy Name | Women's Hospital
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License Number |
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License Number State |
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Taxonomy #10
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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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Taxonomy #11
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #15
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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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