Healthcare Provider Details

I. General information

NPI: 1720909740
Provider Name (Legal Business Name): GOLDEN YEARS MEDICAL HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4137 CARMICHAEL RD OFC 200-15
MONTGOMERY AL
36106-3614
US

IV. Provider business mailing address

1768 BENSON ST
PRATTVILLE AL
36066-1958
US

V. Phone/Fax

Practice location:
  • Phone: 334-314-0143
  • Fax:
Mailing address:
  • Phone: 334-235-3262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KYANA JONES
Title or Position: RN OWNER
Credential:
Phone: 334-235-3262