Healthcare Provider Details

I. General information

NPI: 1710653175
Provider Name (Legal Business Name): GOLDEN HEART HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 CHERRY ST
KANSAS CITY MO
64106-1217
US

IV. Provider business mailing address

511 CHERRY ST
KANSAS CITY MO
64106-1217
US

V. Phone/Fax

Practice location:
  • Phone: 816-800-4022
  • Fax: 816-800-9949
Mailing address:
  • Phone: 816-800-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN NGUYEN
Title or Position: COORDINATOR
Credential: PHARMD
Phone: 816-289-9940