Healthcare Provider Details

I. General information

NPI: 1073440145
Provider Name (Legal Business Name): GOLDEN HEART CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 VILLAGE MILL DR
PICKERINGTON OH
43147-1563
US

IV. Provider business mailing address

841 VILLAGE MILL DR
PICKERINGTON OH
43147-1563
US

V. Phone/Fax

Practice location:
  • Phone: 614-604-4795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: SHIN TEBONG
Title or Position: CEO
Credential:
Phone: 614-604-4795