Provider Demographics
NPI:1104332444
Name:GOODWILL INDUSTRIES OF THE COLUMBIA, INC.
Entity type:Organization
Organization Name:GOODWILL INDUSTRIES OF THE COLUMBIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-734-0400
Mailing Address - Street 1:815 N KELLOGG ST STE A
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:815 N KELLOGG ST STE A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8007
Practice Address - Country:US
Practice Address - Phone:509-734-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management