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General NPI Number Information
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NPI Number | 1093397002
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Entity Type | Organization
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Legal Business Name | GOLDENYEARS GUARDIANSHIP SERVICES, INC.
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 84 BONITA VISTA RD
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City | MOUNT VERNON
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State | NY
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Zip | 10552-1348
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Country | US
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Telephone | 914-522-5205
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Fax | 914-940-6396
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Provider Business Mailing Address
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Address Line | 84 BONITA VISTA RD
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City | MOUNT VERNON
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State | NY
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Zip | 10552-1348
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Country | US
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Telephone | 914-522-5205
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BENJAMIN ALEXANDER MONTGOMERY
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Credential |
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Telephone | 914-522-5205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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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 #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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