Healthcare Provider Details
I. General information
NPI: 1053681775
Provider Name (Legal Business Name): GOLDEN DAYS MEDICAL DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2012
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4601 HOLLINS FERRY RD STE C
BALTIMORE MD
21227-4625
US
IV. Provider business mailing address
4601 HOLLINS FERRY RD STE C
BALTIMORE MD
21227-4625
US
V. Phone/Fax
- Phone: 410-242-6650
- Fax: 410-242-6999
- Phone: 410-242-6650
- Fax: 410-242-6999
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZLATA
GEKHT
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 410-242-6650