Organization Active NPI

Divine Guardian Health Association

  • Case Manager/Care Coordinator
  • Edison, NJ
National Provider Identifier
1114622099
Registry record updated Mar 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
DIVINE GUARDIAN HEALTH ASSOCIATION
Practice address
6 Kilmer Rd # 1328
Edison, NJ 08817-2432
Phone
(973) 847-3006
NPI assigned
Mar 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2026

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

Authorized official

Name
Jodian Walters
Title
Ceo
Phone
(973) 847-3006

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X Primary
Case Management Agency 251B00000X
Community Based Hospice Care Agency 251G00000X
Supports Brokerage Agency 251X00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Addresses

Primary practice location

6 Kilmer Rd # 1328
Edison, NJ 08817-2432

Mailing address

6 Kilmer Rd # 1328
Edison, NJ 08817-2432
Phone (973) 847-3006

National Provider Directory

National Provider Directory

Locations

6 Kilmer Rd
#1328
Edison, NJ 08817
Phone (973) 847-3006

485C US Highway 1 S
Ste 10024
Iselin, NJ 08830

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774742400000",
    "number": "1114622099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 KILMER RD # 1328",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172432",
            "telephone_number": "973-847-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 KILMER RD # 1328",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172432",
            "telephone_number": "973-847-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GUARDIAN HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2026-03-29",
        "certification_date": "2026-03-29",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "JODIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-847-3006"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2026; 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.