Organization
GOOD SHEPHERD DDD SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAGAE W. WASSEF (MANAGER/MEMBER)
(973) 930-5687
Entity
Organization
Contact information
Practice address
725 VALLEY BROOK AVE, LYNDHURST, NJ 07071-2030
(201) 933-0711
(201) 933-0611
Mailing address
725 VALLEY BROOK AVE, LYNDHURST, NJ 07071-2030
(201) 933-0711
(201) 933-0611
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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