Provider Demographics
NPI:1699219543
Name:GOODWILL BENEFITS GROUP, LLC
Entity type:Organization
Organization Name:GOODWILL BENEFITS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BROKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:GOODWILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-845-6721
Mailing Address - Street 1:10180 S WASATCH BLVD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4575
Mailing Address - Country:US
Mailing Address - Phone:801-845-6721
Mailing Address - Fax:801-878-4686
Practice Address - Street 1:10180 S WASATCH BLVD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4575
Practice Address - Country:US
Practice Address - Phone:801-845-6721
Practice Address - Fax:801-878-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT148026251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage