NPIMap

Organization Active NPI

Good Care Network LLC

  • Assisted Living Facility (Mental Illness)
  • Prescott, AZ
National Provider Identifier
1508493016
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
GOOD CARE NETWORK LLC
Practice address
4775 E Kristen Dr
Prescott, AZ 86301-5803
Phone
(313) 434-2723
NPI assigned
Mar 25, 2020
Last updated
Mar 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Authorized official

Name
Dominique GiddingsNPI 1598125858
Title
Executive Director
Phone
(313) 434-2723

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X NU Primary

Addresses

Primary practice location

4775 E Kristen Dr
Prescott, AZ 86301-5803

Mailing address

4775 E Kristen Dr
Prescott, AZ 86301-5803
Phone (313) 434-2723

National Provider Directory

National Provider Directory
Tax ID family
Good Care Network LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1508493016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 E KRISTEN DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015803",
            "telephone_number": "313-434-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 E KRISTEN DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015803",
            "telephone_number": "313-434-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD CARE NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "GIDDINGS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-434-2723"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.