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General NPI Number Information
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NPI Number | 1407190697
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Entity Type | Organization
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Legal Business Name | GOLDEN YEARS HOME CARE OF INDIANA INC
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Dates
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Enumeration Date | 11/12/2012
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 4334 E 3RD ST SUITE 200
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5547
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Country | US
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Telephone | 812-822-0145
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Fax | 812-822-0152
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Provider Business Mailing Address
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Address Line | 4334 E 3RD ST SUITE 200
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5547
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Country | US
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Telephone | 812-822-0145
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Fax | 812-822-0152
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ANN MARIE HARRISON
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Credential | RN
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Telephone | 812-822-0145
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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 | 09-012240-1
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License Number State | IN
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