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General NPI Number Information
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NPI Number | 1164120341
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Entity Type | Organization
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Legal Business Name | GOSHEN HOME AND CARE SERVICES LLC
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 04/01/2023
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Provider Practice Location Address
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Address Line | 33636 GERTRUDE STREET
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City | WAYNE
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State | MI
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Zip | 48184
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Country | US
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Telephone | 734-419-1337
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Fax |
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Provider Business Mailing Address
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Address Line | 33636 GERTRUDE STREET
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City | WAYNE
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State | MI
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Zip | 48184
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Country | US
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Telephone | 734-419-1337
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADESHOLA HUTCHINS
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Credential |
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Telephone | 734-419-1337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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