| Goshen Valley Foundation Inc | |
|
230 Marietta Hwy Canton GA 30114-2327 | |
| (770) 789-3797 | |
| (404) 937-5580 |
| Full Name | Goshen Valley Foundation Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 230 Marietta Hwy, Canton, Georgia |
| Authorized Official Name and Position | Stacy Leann Sabaka (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7703241215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goshen Valley Foundation Inc 387 Goshen Church Way Waleska GA 30183-2347 Ph: (770) 324-1215 | Goshen Valley Foundation Inc 230 Marietta Hwy Canton GA 30114-2327 Ph: (770) 789-3797 |
| NPI Number | 1710238787 |
|---|---|
| Provider Enumeration Date | 10/01/2012 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Medicare PECOS PAC ID | 1254879430 |
|---|---|
| Medicare Enrollment ID | O20240819004215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710238787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Karen Williams |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497342968 PECOS PAC ID: 6406395425 Enrollment ID: I20240822000714 |
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