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General NPI Number Information
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NPI Number | 1295758654
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Entity Type | Organization
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Legal Business Name | GOLDEN AGE HOME CARE, INC.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 3408 W 84TH ST SUITE 211
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City | HIALEAH
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State | FL
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Zip | 33018-4939
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Country | US
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Telephone | 305-824-0355
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Fax | 305-827-9021
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Provider Business Mailing Address
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Address Line | 3408 W 84TH ST SUITE 211
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City | HIALEAH
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State | FL
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Zip | 33018-4939
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Country | US
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Telephone | 305-824-0355
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Fax | 305-827-9021
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Authorized Official
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Title or Position | ADMIISTRATOR
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Name | MRS. BARBARA BAEZ
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Credential |
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Telephone | 305-824-0355
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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 | 21437096
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License Number State | FL
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