Healthcare Provider Details
I. General information
NPI: 1265320394
Provider Name (Legal Business Name): GOLDEN CARE THERAPY MINNESOTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2136 FORD PKWY # 5259
SAINT PAUL MN
55116-2850
US
IV. Provider business mailing address
4770 WHITE PLAINS RD
BRONX NY
10470-1136
US
V. Phone/Fax
- Phone: 218-225-8785
- Fax: 732-810-0385
- Phone: 732-730-0700
- Fax: 732-810-0385
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AKIVA
TOPPER
Title or Position: COO
Credential:
Phone: 732-730-0700