Healthcare Provider Details

I. General information

NPI: 1164605234
Provider Name (Legal Business Name): GOLDEN YEARS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 JACKSON ST 1A
FREEHOLD NJ
07728-2476
US

IV. Provider business mailing address

1027 ROUTE 34
ABERDEEN NJ
07747-2359
US

V. Phone/Fax

Practice location:
  • Phone: 732-845-3332
  • Fax: 732-845-3339
Mailing address:
  • Phone: 732-845-3332
  • Fax: 732-845-3339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number13001
License Number StateNJ

VIII. Authorized Official

Name: MRS. GALINA GOLDEN
Title or Position: MANAGING MEMBER
Credential:
Phone: 732-845-3332