Healthcare Provider Details

I. General information

NPI: 1376233114
Provider Name (Legal Business Name): GOLDEN HEARTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 VILLAGE CIR STE 1
SLIDELL LA
70458-5418
US

IV. Provider business mailing address

124 CAWTHORN DR
SLIDELL LA
70458-1554
US

V. Phone/Fax

Practice location:
  • Phone: 985-288-8961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SIMONE PITRE
Title or Position: OWNER
Credential:
Phone: 985-288-8961