Healthcare Provider Details

I. General information

NPI: 1497356612
Provider Name (Legal Business Name): GOLDEN HOUR CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 S APPLE ST APT 104
BOISE ID
83706-6823
US

IV. Provider business mailing address

3185 S APPLE ST APT 104
BOISE ID
83706-6823
US

V. Phone/Fax

Practice location:
  • Phone: 208-513-5855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: AYAN MOHAMED
Title or Position: OWNER
Credential:
Phone: 208-513-5855