| Good Friends Of Children With Childhood Developmental Disabilities | |
|
39 Wainwright St Newark NJ 07112-1333 | |
| (973) 204-2210 | |
| (973) 991-1257 |
| Full Name | Good Friends Of Children With Childhood Developmental Disabilities |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 39 Wainwright St, Newark, New Jersey |
| Authorized Official Name and Position | Patt Oluwasina Ogunwale (PRESIDENT/CEO) |
| Authorized Official Contact | 9732042210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Friends Of Children With Childhood Developmental Disabilities Po Box 8774 Newark NJ 07108-0774 Ph: (973) 204-2210 | Good Friends Of Children With Childhood Developmental Disabilities 39 Wainwright St Newark NJ 07112-1333 Ph: (973) 204-2210 |
| NPI Number | 1093970741 |
|---|---|
| Provider Enumeration Date | 07/22/2008 |
| Last Update Date | 07/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093970741 | NPI | - | NPPES |
| 0161616 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0161616 (New Jersey) | Primary |
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