Healthcare Provider Details

I. General information

NPI: 1578074332
Provider Name (Legal Business Name): GOLDENCARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12929 E 21ST ST
TULSA OK
74134-1001
US

IV. Provider business mailing address

12929 E 21ST ST
TULSA OK
74134-1001
US

V. Phone/Fax

Practice location:
  • Phone: 918-779-7608
  • Fax: 918-779-7580
Mailing address:
  • Phone: 918-779-7608
  • Fax: 918-779-7580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberCSS0080
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberCSS0800
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberCSS0800
License Number StateOK

VIII. Authorized Official

Name: ASHLEY NICOLE BROWN-HAYES
Title or Position: DIRECTOR
Credential:
Phone: 918-779-7608