NPIMap

Organization Active NPI

Good Care Network LLC

  • Assisted Living Facility (Behavioral Disturbances)
  • Surprise, AZ
National Provider Identifier
1730684754
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
Legal business name
GOOD CARE NETWORK LLC
Practice address
13250 W Port Royale LN
Surprise, AZ 85379-6520
Phone
(928) 299-2952
NPI assigned
Mar 30, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dominique GiddingsNPI 1598125858
Title
Administrator/Owner
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 (Behavioral Disturbances) 3104A0630X NU Primary

Addresses

Primary practice location

13250 W Port Royale LN
Surprise, AZ 85379-6520

Mailing address

378 N Shore LN
Gilbert, AZ 85233-4702
Phone (313) 434-2723

Other identifiers 1

IdentifierTypeStateIssuer
000000000MedicaidAZ

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": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1730684754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 N SHORE LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852334702",
            "telephone_number": "313-434-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13250 W PORT ROYALE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853796520",
            "telephone_number": "928-299-2952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD CARE NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "GIDDINGS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "313-434-2723"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.