Organization
DIVINE GUARDIAN HEALTH ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIAN WALTERS (CEO)
(973) 847-3006
Entity
Organization
Contact information
Practice address
6 KILMER RD # 1328, EDISON, NJ 08817-2432
(973) 847-3006
Mailing address
6 KILMER RD # 1328, EDISON, NJ 08817-2432
(973) 847-3006
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
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
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