Provider Demographics
NPI:1063727188
Name:GOOD GROUND CHILD ENRICHMENT, INC.
Entity type:Organization
Organization Name:GOOD GROUND CHILD ENRICHMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:914-906-8919
Mailing Address - Street 1:367 NEW WINDSOR HIGHWAY
Mailing Address - Street 2:215
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-4925
Mailing Address - Country:US
Mailing Address - Phone:914-906-8919
Mailing Address - Fax:845-567-1118
Practice Address - Street 1:2719 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-4925
Practice Address - Country:US
Practice Address - Phone:914-906-8919
Practice Address - Fax:845-567-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0709231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty