NPI 1447004262

Goforth Residential Services LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Avon, IN

Practice location

Address: 2413 Prophetstown Rd, Avon, IN 46123-5921
Phone: (518) 269-8299

Authorised official

Name: Jeanne Sinzinkayo
Title: Manager
Phone: (518) 269-8299

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1447004262
Entity type: Organization
NPI issued: 16 Apr 2024
Record last updated: 16 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.