Healthcare Provider Details
I. General information
NPI: 1164126330
Provider Name (Legal Business Name): GOLDEN ERA ADHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2023
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4 UNION SQ
UNION CITY CA
94587-3523
US
IV. Provider business mailing address
2638 RAINIER CT
UNION CITY CA
94587-4923
US
V. Phone/Fax
- Phone: 408-300-2367
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
HANH
GIANG
Title or Position: MANAGING MEMBER
Credential:
Phone: 408-300-2367