# GOSHEN COMMUNITY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093604084
- **Authorized official:** MR. MARCEL KALONGA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (704) 361-9868

## Contact information

- **Practice address:** 3306 N 190TH PLZ, ELKHORN, NE 68022-3554
- **Practice address phone:** (402) 252-4497
- **Mailing address:** 3306 N 190TH PLZ, ELKHORN, NE 68022-3554
- **Mailing address phone:** (402) 252-4497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | NULL | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 07/02/2025
- **Last updated:** 07/02/2025