Healthcare Provider Details

I. General information

NPI: 1689289969
Provider Name (Legal Business Name): GOLDEN LIFE SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2020
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5499 NOKOMIS CIR
ORLANDO FL
32839-7317
US

IV. Provider business mailing address

5499 NOKOMIS CIR
ORLANDO FL
32839-7317
US

V. Phone/Fax

Practice location:
  • Phone: 407-706-7575
  • Fax:
Mailing address:
  • Phone: 407-706-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDITH FLETCHER
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 407-706-7575