Healthcare Provider Details

I. General information

NPI: 1720197668
Provider Name (Legal Business Name): GOLDEN RULE CARE PROVIDER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 CLAUSE DR
BREAUX BRIDGE LA
70517-4708
US

IV. Provider business mailing address

525 CLAUSE DR
BREAUX BRIDGE LA
70517-4708
US

V. Phone/Fax

Practice location:
  • Phone: 337-332-4005
  • Fax:
Mailing address:
  • Phone: 337-332-4005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MARY P MORAIN
Title or Position: OWNER
Credential:
Phone: 337-623-4100