Healthcare Provider Details

I. General information

NPI: 1144193160
Provider Name (Legal Business Name): GOLDENHEART CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 ENTRADA SONATA
SANTA FE NM
87507-2663
US

IV. Provider business mailing address

4212 ENTRADA SONATA
SANTA FE NM
87507-2663
US

V. Phone/Fax

Practice location:
  • Phone: 505-900-1159
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NIBA SHU OLIVIER
Title or Position: CEO
Credential:
Phone: 505-900-1159