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General NPI Number Information
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NPI Number | 1053895698
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Entity Type | Organization
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Legal Business Name | HEART OF GOLD HOMECARE, LLC
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 03/06/2021
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Provider Practice Location Address
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Address Line | 101 ROUTE 130 S STE 6
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City | CINNAMINSON
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State | NJ
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Zip | 08077-2843
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Country | US
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Telephone | 856-389-5637
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Fax | 856-861-1429
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Provider Business Mailing Address
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Address Line | 101 ROUTE 130 S STE 6
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City | CINNAMINSON
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State | NJ
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Zip | 08077-2843
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Country | US
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Telephone | 856-389-5637
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Fax | 856-861-1429
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | LATASHA S BUTLER
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Credential | RN
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Telephone | 856-389-5637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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