Provider Demographics
NPI:1639910284
Name:EMDAZZ GOALS OF HOME HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:EMDAZZ GOALS OF HOME HEALTH CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAZZLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAAME-GYAMFUA
Authorized Official - Suffix:
Authorized Official - Credentials:DON
Authorized Official - Phone:973-641-5363
Mailing Address - Street 1:1617 ROUTE 88 STE 205
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3010
Mailing Address - Country:US
Mailing Address - Phone:609-906-1179
Mailing Address - Fax:732-860-9994
Practice Address - Street 1:1617 ROUTE 88
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3010
Practice Address - Country:US
Practice Address - Phone:609-906-1179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care