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General NPI Number Information
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NPI Number | 1093868846
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Entity Type | Organization
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Legal Business Name | GOLDEN AGE RAINBOW SERVICES INC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1300 BAXTER ST SUITE 240
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City | CHARLOTTE
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State | NC
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Zip | 28204-3053
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Country | US
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Telephone | 704-333-7583
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Fax | 704-333-7605
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Provider Business Mailing Address
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Address Line | 1300 BAXTER STREET SUITE 240
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City | CHARLOTTE
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State | NC
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Zip | 28204
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Country | US
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Telephone | 704-333-7583
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Fax | 704-333-7605
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Authorized Official
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Title or Position | OWNER
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Name | MS. ACQUIRNETA DARNELL MCNAIR
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Credential | CNA
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Telephone | 704-333-7583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number | HC2275
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC2275
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | HC2275
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License Number State | NC
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