Whalio Doctors

NPI 1871717223

Adec - Goshen Men

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Goshen, IN

Practice location

Address
1717 Longwood CT, Goshen, IN 46526-1469
Phone
(574) 848-7451
Fax
(574) 848-5917
Mailing address
19670 Sr 120, Bristol, IN 46507-0398

Authorised official

Name
Paula M Shively
Title
Ceo
Phone
(574) 848-5751

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X Licence 2670I0011DE08 (IN)

Registry record

NPI
1871717223
Entity type
Organization
NPI issued
13 Apr 2007
Record last updated
22 Aug 2020

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.