MEDICARE: GOLDEN THREAD HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1902788664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN THREAD HOME CARE LLC

Provider Business Mailing Address
First Line	:	3102 SABA LN
Second Line	:
City	:	PORT NECHES
State	:	TX
Zip	:	77651-5422
Country	:	US
Telephone Number	:	409-288-0961
Fax Number	:

Provider Business Practice Location Address
First Line	:	3102 SABA LN
Second Line	:
City	:	PORT NECHES
State	:	TX
Zip	:	77651-5422
Country	:	US
Telephone Number	:	409-288-0961
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	LAURA VICTORES WYMAN
Credential	:
Telephone Number	:	832-580-3955

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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