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General NPI Number Information
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NPI Number | 1174413249
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Entity Type | Organization
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Legal Business Name | GOLDEN HAVEN CARE SERVICES LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 107 NEW ST APT 304
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City | EAST ORANGE
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State | NJ
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Zip | 07017-4146
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Country | US
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Telephone | 973-704-4414
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Fax |
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Provider Business Mailing Address
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Address Line | 107 NEW ST APT 304
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City | EAST ORANGE
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State | NJ
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Zip | 07017-4146
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Country | US
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Telephone | 973-704-4414
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | TANIEL VIOLA MOORE
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Credential |
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Telephone | 973-704-4414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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