MEDICARE: DEVELOPMENTAL GOALS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104570530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVELOPMENTAL GOALS, INC

Provider Business Mailing Address
First Line	:	1128 HIDDEN VALLEY WAY
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-1815
Country	:	US
Telephone Number	:	954-232-5690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1128 HIDDEN VALLEY WAY
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-1815
Country	:	US
Telephone Number	:	954-232-5690
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEBRA GOBOFF
Credential	:
Telephone Number	:	954-232-5690

Provider Enumeration Date	:	02/04/2022
Last Update Date	:	02/04/2022

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Directions to “DEVELOPMENTAL GOALS, INC ” Practice Location

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