Healthcare Provider Details

I. General information

NPI: 1801703905
Provider Name (Legal Business Name): GOLDENYEARCAREGIVINGLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7045 BONNAVENT DR
HERMITAGE TN
37076-1015
US

IV. Provider business mailing address

7045 BONNAVENT DR
HERMITAGE TN
37076-1015
US

V. Phone/Fax

Practice location:
  • Phone: 629-263-9100
  • Fax:
Mailing address:
  • Phone: 629-263-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. TIESHA JONES
Title or Position: CAREGIVER
Credential:
Phone: 629-263-9100