Goshen Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23H948 Issued in CO

Legal business name

GOSHEN ASSISTED LIVING LLC

Practice address

12099 E Louisiana Ave
Aurora, CO 80012-4255

Phone

(303) 353-9041

Fax

(303) 353-2334

NPI assigned

Mar 21, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Harijanto Sugiarso

Title

President

Phone

(303) 353-9041

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1992070080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12099 E LOUISIANA AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124255",
            "telephone_number": "303-353-9041",
            "fax_number": "303-353-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12099 E LOUISIANA AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124255",
            "telephone_number": "303-353-9041",
            "fax_number": "303-353-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "SUGIARSO",
        "authorized_official_first_name": "HARIJANTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-353-9041",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23H948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Gorvetzian, MD
• Kara Gosch, DPT
• Emily Erin Gosche, MD
• Bobby Denzel Gosey Jr., MD
• Tykwa Goshay
• Daniel Gospodarek, MSW
• Foster Reed Goss, D.O.
• Jennifer Ann Goss, RN, LE
• Margaret Goss
• Kayla Gosselink

• Assisted Living Facility in Aurora, CO
• Providers in Aurora, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.