Healthcare Provider Details

I. General information

NPI: 1992057459
Provider Name (Legal Business Name): GOLDEN HEART ADULT DAY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SHORE RD
SOMERS POINT NJ
08244
US

IV. Provider business mailing address

101 SHORE RD
SOMERS POINT NJ
08244
US

V. Phone/Fax

Practice location:
  • Phone: 609-788-0067
  • Fax: 609-788-0068
Mailing address:
  • Phone: 609-788-0067
  • Fax: 609-788-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number018253
License Number StateNJ

VIII. Authorized Official

Name: SPARSHIL I PATEL
Title or Position: C.E.O.
Credential: M.D., M.P.H., C.A.L.
Phone: 609-788-0067