Goodknight the Clubhouse Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

GOODKNIGHT THE CLUBHOUSE INC.

Practice address

645 Walnut St.
Reading, PA 19601

Phone

(484) 755-5980

NPI assigned

Apr 6, 2021

Last updated

Jun 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Wayne R Goodman Sr.

Title

Ceo

Phone

(484) 769-3028

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1285213363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 BAYWOOD AVE.",
            "city": "WERNERSVILLE",
            "state": "PA",
            "postal_code": "19565",
            "telephone_number": "484-769-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 WALNUT ST.",
            "city": "READING",
            "state": "PA",
            "postal_code": "19601",
            "telephone_number": "484-755-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODKNIGHT THE CLUBHOUSE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "484-769-3028",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Gomez Santos
• Jocelina Gomez-Baez, BSW
• Karina Gonzalez Saunders, PA-C
• Elizabeth W Gonzalez, L.P.C., R.P.T.
• Erin Goodhart
• Lonelle Tayvon Goodwin
• Kaelor Kelly-Ann Gordon, DO
• Kelly Gorman
• Veronica Gottsch, MSN, CRNP, PMHNP-BC
• Nura Gouda, DO

• Mental Illness Community Based Residential Treatment Facility in Reading, PA
• Providers in Reading, PA by specialty
• Mental Illness Community Based Residential Treatment Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.