Provider Demographics
NPI:1821665027
Name:GODJE INC
Entity Type:Organization
Organization Name:GODJE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-872-2310
Mailing Address - Street 1:1580 OAKLAND RD STE C112
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2400
Mailing Address - Country:US
Mailing Address - Phone:408-872-2310
Mailing Address - Fax:408-588-1619
Practice Address - Street 1:1580 OAKLAND RD STE C112
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2400
Practice Address - Country:US
Practice Address - Phone:408-872-2310
Practice Address - Fax:408-588-1619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty