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Organization

GOSHEN COMMUNITY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARCEL KALONGA (EXECUTIVE DIRECTOR)
(704) 361-9868
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
07/02/2025
Last updated
07/02/2025
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