Healthcare Provider Details

I. General information

NPI: 1942404975
Provider Name (Legal Business Name): GOLDENCARE ADHC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 B HWY 62 412
HIGHLAND AR
72542
US

IV. Provider business mailing address

PO BOX 359
CHEROKEE VILLAGE AR
72525-0359
US

V. Phone/Fax

Practice location:
  • Phone: 870-856-2090
  • Fax:
Mailing address:
  • Phone: 870-856-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY TOROSYAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 870-856-2090