Healthcare Provider Details

I. General information

NPI: 1558206169
Provider Name (Legal Business Name): GOLDEN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 814-566-7394
  • Fax: 313-397-0454
Mailing address:
  • Phone: 814-566-7394
  • Fax: 313-397-0454

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: LEONARDO ADRIANO
Title or Position: OWNER
Credential:
Phone: 814-566-7394