Provider Demographics
NPI:1528476405
Name:GOSHEN HEALTHCARE &HOSPICE SERVICES
Entity type:Organization
Organization Name:GOSHEN HEALTHCARE &HOSPICE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:BALAY
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-537-7993
Mailing Address - Street 1:44754 W DESERT GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-9171
Mailing Address - Country:US
Mailing Address - Phone:972-537-7993
Mailing Address - Fax:940-808-0960
Practice Address - Street 1:44754 W DESERT GARDEN RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-9171
Practice Address - Country:US
Practice Address - Phone:972-537-7993
Practice Address - Fax:940-808-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health