Healthcare Provider Details

I. General information

NPI: 1578759650
Provider Name (Legal Business Name): GOLDEN DREAMS HOMECARE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 PINEHILL RD
BETTENDORF IA
52722-1719
US

IV. Provider business mailing address

1311 PINEHILL RD
BETTENDORF IA
52722-1719
US

V. Phone/Fax

Practice location:
  • Phone: 563-386-6246
  • Fax: 563-355-2433
Mailing address:
  • Phone: 563-386-6246
  • Fax: 563-355-2433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA MAE ALBERT
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 563-386-6246