Healthcare Provider Details

I. General information

NPI: 1093607467
Provider Name (Legal Business Name): GOLDEN ERA PERSONAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 E SAHARA AVE STE 212
LAS VEGAS NV
89104-3707
US

IV. Provider business mailing address

PO BOX 43753
LAS VEGAS NV
89116-1753
US

V. Phone/Fax

Practice location:
  • Phone: 702-207-0842
  • Fax:
Mailing address:
  • Phone:
  • 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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARIELA DELGADO
Title or Position: ADMINISTRATOR
Credential:
Phone: 928-201-2579