MEDICARE: MY GOAL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	253Z00000X	In Home Supportive Care Agency
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1144796889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY GOAL

Provider Business Mailing Address
First Line	:	PO BOX 531
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-0531
Country	:	US
Telephone Number	:	732-616-5060
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 WAVERLY PL
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-2705
Country	:	US
Telephone Number	:	877-886-9462
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	GENEVIEVE KUMAPLEY
Credential	:	PHARMD
Telephone Number	:	877-886-9462

Provider Enumeration Date	:	10/20/2018
Last Update Date	:	10/20/2018

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Directions to “MY GOAL ” Practice Location

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