NPIMap

Organization Active NPI

Grandular Senior Living

  • Day Training/Habilitation Specialist
  • Sicklerville, NJ
National Provider Identifier
1831686443
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
License
0450254579 Issued in NJ
Legal business name
GRANDULAR SENIOR LIVING
Practice address
542 Berlin Cross Key Road Ste 3-270
Sicklerville, NJ 08081
Phone
(856) 875-9608
NPI assigned
Apr 18, 2018
Last updated
Apr 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Authorized official

Name
Mrs. Deborah Dickerson, ED.S
Title
Owner
Phone
(856) 875-9605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X 0450254579 NJ Primary

Addresses

Primary practice location

542 Berlin Cross Key Road Ste 3-270
Sicklerville, NJ 08081

Mailing address

542 Berlin Cross Key Road Ste 3-270
Sicklerville, NJ 08081
Phone (856) 875-9608

National Provider Directory

National Provider Directory
Tax ID family
Grandular Health Services 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.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1831686443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 BERLIN CROSS KEY ROAD STE 3-270",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "08081",
            "telephone_number": "856-875-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 BERLIN CROSS KEY ROAD STE 3-270",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "08081",
            "telephone_number": "856-875-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDULAR SENIOR LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-875-9605",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ED.S"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NJ",
            "license": "0450254579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.