Good Friends of Children With Childhood Developmental Disabilities

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0161616 Issued in NJ

Legal business name

GOOD FRIENDS OF CHILDREN WITH CHILDHOOD DEVELOPMENTAL DISABILITIES

Practice address

39 Wainwright St
Newark, NJ 07112-1333

Phone

(973) 204-2210

Fax

(973) 991-1257

NPI assigned

Jul 22, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Patt Oluwasina Ogunwale

Title

President/Ceo

Phone

(973) 204-2210

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1093970741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8774",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071080774",
            "telephone_number": "973-204-2210",
            "fax_number": "973-991-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WAINWRIGHT ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071121333",
            "telephone_number": "973-204-2210",
            "fax_number": "973-991-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD FRIENDS OF CHILDREN WITH CHILDHOOD DEVELOPMENTAL DISABILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "OGUNWALE",
        "authorized_official_first_name": "PATT",
        "authorized_official_middle_name": "OLUWASINA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "973-204-2210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "0161616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161616",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mario Segundo Gonzalez, MD FCAP FASCP
• Taylor A Gonzalez, MD
• Joslainez Gonzalo
• Good Care Med LLC
• Good Care Pediatrics, LLC
• Good Harvest Fraternal Group
• Chastity Gooden-Clyne
• Lashun Goodman
• Goodwill Industries of Greater Ny & Northern NJ, Inc
• Candace Gordon

• Community/Behavioral Health Agency in Newark, NJ
• Providers in Newark, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.