Provider Demographics
NPI:1497479448
Name:GOSHEN RESCARE LLC
Entity Type:Organization
Organization Name:GOSHEN RESCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUSHIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-717-8976
Mailing Address - Street 1:1887 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2186
Mailing Address - Country:US
Mailing Address - Phone:603-717-8976
Mailing Address - Fax:
Practice Address - Street 1:1887 BROOKVIEW DR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2186
Practice Address - Country:US
Practice Address - Phone:603-717-8976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities