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General NPI Number Information
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NPI Number | 1356409296
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Entity Type | Organization
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Legal Business Name | GOLDEN ANGEL CARING HEARTS
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 842 RANCH RD
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City | QUINCY
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State | FL
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Zip | 32351-5265
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Country | US
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Telephone | 850-627-7533
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1230
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City | QUINCY
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State | FL
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Zip | 32353-1230
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Country | US
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Telephone | 850-627-7533
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Fax |
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Authorized Official
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Title or Position | HOMEMAKER & COMPANION
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Name | MISS QUANTARA L CLARKE
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Credential |
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Telephone | 850-627-7533
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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 | 251EOOOOOX
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License Number State | FL
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