Provider Demographics
NPI:1376139527
Name:GOSHEN TOTAL CARE
Entity Type:Organization
Organization Name:GOSHEN TOTAL CARE
Other - Org Name:GOSHEN TOTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENIFFET
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-656-1737
Mailing Address - Street 1:1013 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3816
Mailing Address - Country:US
Mailing Address - Phone:484-656-1737
Mailing Address - Fax:
Practice Address - Street 1:1013 S 12TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3816
Practice Address - Country:US
Practice Address - Phone:484-656-1737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA84-4251659OtherNON MEDICAL HHA