Organization
GOSHEN DEVELOPMENTAL DISABILITY CENTER
Active
Other names
Goshen DDC
Organization subpart
No
Provider details
NPI number
Authorized official
MARCEL KALONGA (EXECUTIVE DIRECTOR)
(704) 361-9868
Entity
Organization
Contact information
Practice address
617 MORNINGSIDE RD, CHARLOTTE, NC 28214-9105
(704) 361-9868
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
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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