Provider Demographics
NPI:1902234859
Name:GOSHEN HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:GOSHEN HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTHONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEIGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-954-0124
Mailing Address - Street 1:3410 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-6678
Mailing Address - Country:US
Mailing Address - Phone:903-954-0124
Mailing Address - Fax:903-565-4727
Practice Address - Street 1:3410 LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-6678
Practice Address - Country:US
Practice Address - Phone:903-954-0124
Practice Address - Fax:903-565-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health