Organization Name: | GODUSI LLC |
NPI Number: | 1003292160 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMIR GHODDOUSSI (OWNER) |
Mailing Address: | 2505 S 17th St Ste 110 Wilmington |
State: | NC US |
Postal Code: | 284017992 |
Phone Number: | 9103420455 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2015 |
NPI Last Update Date: | 07/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | HC3797 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |