Goodwillhomescommunityservices, Inc.

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

SO/10802A Issued in TN

Legal business name

GOODWILLHOMESCOMMUNITYSERVICES, INC.

Practice address

4590 Goodwill Rd
Memphis, TN 38109-5714

Phone

(901) 785-6790

Fax

(901) 789-8351

NPI assigned

Jun 30, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Susan M. Mills

Title

Chief Executiveofficer

Phone

(901) 785-6790

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1538456348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161282",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381861282",
            "telephone_number": "901-785-6790",
            "fax_number": "901-789-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 GOODWILL RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381095714",
            "telephone_number": "901-785-6790",
            "fax_number": "901-789-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILLHOMESCOMMUNITYSERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVEOFFICER",
        "authorized_official_telephone_number": "901-785-6790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "TN",
            "license": "SO/10802A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1450144",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Cates Goodman, M.D.
• Stephanie Goodrich, LMSW
• Max Parker Goodsell, DO
• Ashley Goodson
• Mackenzie Goodspeed
• Autumn Joi Goodwin-Samson, M.D.
• Salil Goorha, M.D.
• Kunj Arun Gor, MBBS
• Vijaya Kumar Gorantla, M.D
• Gordon Heart Clinic PC

• Foster Care Agency in Memphis, TN
• Providers in Memphis, TN by specialty
• Foster Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.