MEDICARE: GOOD CARE,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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1457107013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD CARE,INC.

Provider Business Mailing Address
First Line	:	719 S OAKLAND AVE
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54304-2614
Country	:	US
Telephone Number	:	612-297-2798
Fax Number	:

Provider Business Practice Location Address
First Line	:	719 S OAKLAND AVE
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54304-2614
Country	:	US
Telephone Number	:	612-297-2798
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NUH JAMA
Credential	:	OWNER
Telephone Number	:	612-296-2798

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

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Directions to “GOOD CARE,INC. ” Practice Location

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