Provider Demographics
NPI:1912545716
Name:GOSHEN HEALTHCARE INC
Entity Type:Organization
Organization Name:GOSHEN HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/AGENCY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:O
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-507-5127
Mailing Address - Street 1:3365 N ARLINGTON HEIGHTS RD STE G
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-7700
Mailing Address - Country:US
Mailing Address - Phone:773-507-5127
Mailing Address - Fax:224-735-2380
Practice Address - Street 1:3365 N ARLINGTON HEIGHTS RD STE G
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7700
Practice Address - Country:US
Practice Address - Phone:773-507-5127
Practice Address - Fax:224-735-2380
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOSHEN HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty