Healthcare Provider Details

I. General information

NPI: 1184161309
Provider Name (Legal Business Name): GOLDEN SUN HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3069 AMWILER RD STE 4
ATLANTA GA
30360-2825
US

IV. Provider business mailing address

3069 AMWILER RD STE 4
ATLANTA GA
30360-2825
US

V. Phone/Fax

Practice location:
  • Phone: 678-861-8889
  • Fax: 770-456-5045
Mailing address:
  • Phone: 678-861-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number067-R-1470
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number067-R-1470
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number067-R-1470
License Number StateGA

VIII. Authorized Official

Name: ALFRED SOMBOUN YIN
Title or Position: CEO
Credential:
Phone: 678-861-8889