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Organization

GOOD FRIENDS OF CHILDREN WITH CHILDHOOD DEVELOPMENTAL DISABILITIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PATT OLUWASINA OGUNWALE (PRESIDENT/CEO)
(973) 204-2210
Entity
Organization

Contact information

Practice address
39 WAINWRIGHT ST, NEWARK, NJ 07112-1333
(973) 204-2210
(973) 991-1257
Mailing address
PO BOX 8774, NEWARK, NJ 07108-0774
(973) 204-2210
(973) 991-1257

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0161616
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0161616
NJ
Enumeration date
07/22/2008
Last updated
07/22/2008
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