# DIVINE GUARDIAN HEALTH ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114622099
- **Authorized official:** JODIAN WALTERS (CEO)
- **Authorized official phone:** (973) 847-3006

## Contact information

- **Practice address:** 6 KILMER RD \# 1328, EDISON, NJ 08817-2432
- **Practice address phone:** (973) 847-3006
- **Mailing address:** 6 KILMER RD \# 1328, EDISON, NJ 08817-2432
- **Mailing address phone:** (973) 847-3006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 251B00000X | Case Management Agency | — | — | — |
| 251G00000X | Community Based Hospice Care Agency | — | — | — |
| 251X00000X | Supports Brokerage Agency | — | — | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | — | — |

## Other

- **Enumeration date:** 03/31/2023
- **Last updated:** 03/29/2026