Healthcare Provider Details

I. General information

NPI: 1437727849
Provider Name (Legal Business Name): GOLDEN CARE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2021
Last Update Date: 06/12/2021
Certification Date: 06/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 VINCENNES RD STE 120
INDIANAPOLIS IN
46268-3055
US

IV. Provider business mailing address

3905 VINCENNES RD STE 120
INDIANAPOLIS IN
46268-3055
US

V. Phone/Fax

Practice location:
  • Phone: 317-802-7616
  • Fax: 317-552-2090
Mailing address:
  • Phone: 317-802-7616
  • Fax: 317-552-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. GYJUANNA TWYMAN
Title or Position: DIRECTOR OF AMDINISTRATION
Credential: ASN MA
Phone: 317-802-7616