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Organization
GOSHEN CITY BEHAVIORAL HEALTH LLC
Active
Organization
GOSHEN CITY BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLI ELIZABETH PERRIN BCBA (PRESIDENT)
(267) 980-8785
Entity
Organization
Contact information
Practice address
203 N 5TH ST, GOSHEN, IN 46528-3226
(267) 980-9785
Mailing address
66208 GRASSLANDS LN, GOSHEN, IN 46526-7323
(267) 980-9785
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NULL
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300027991
—
IN
Enumeration date
04/19/2019
Last updated
04/10/2024
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