Healthcare Provider Details

I. General information

NPI: 1699265264
Provider Name (Legal Business Name): GOLDEN TOUCH HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13339 JASPER CT
FAIRFAX VA
22033-1407
US

IV. Provider business mailing address

13339 JASPER CT
FAIRFAX VA
22033-1407
US

V. Phone/Fax

Practice location:
  • Phone: 703-400-3626
  • Fax:
Mailing address:
  • Phone: 703-400-3626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-1756
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AUGUSTINE DUAH
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 703-400-3626