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General NPI Number Information
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NPI Number | 1396110052
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Entity Type | Organization
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Legal Business Name | GOLDEN YEARS ADULT DAY CARE
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 770 INDUSTRIAL DR
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City | EDMONTON
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State | KY
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Zip | 42129-8944
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Country | US
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Telephone | 270-432-2044
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 210
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City | EDMONTON
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State | KY
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Zip | 42129-0210
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Country | US
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Telephone | 270-432-2044
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TAMMY S. LONG
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Credential |
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Telephone | 270-432-2044
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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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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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