MEDICARE: GOSHEN HEALTHCARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	251F00000X	Home Infusion Agency
3	251J00000X	Nursing Care Agency
4	253Z00000X	In Home Supportive Care Agency
5	374U00000X	Home Health Aide
6	385H00000X	Respite Care
7	251E00000X	Home Health Agency	010216	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588713739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOSHEN HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	1255 W 15TH ST STE 900
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-4214
Country	:	US
Telephone Number	:	972-664-0945
Fax Number	:	972-664-0139

Provider Business Practice Location Address
First Line	:	1255 W 15TH ST STE 900
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-4214
Country	:	US
Telephone Number	:	972-664-0945
Fax Number	:	972-664-0139

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ZACHARY KOENEN
Credential	:
Telephone Number	:	972-664-0945

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	09/30/2024

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Directions to “GOSHEN HEALTHCARE SERVICES, LLC ” Practice Location

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