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General NPI Number Information
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NPI Number | 1427906569
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Entity Type | Organization
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Legal Business Name | GOLDEN YEARS SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 541 ROSERIDGE DR
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-6701
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Country | US
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Telephone | 901-706-7670
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Fax |
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Provider Business Mailing Address
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Address Line | 541 ROSERIDGE DR
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-6701
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Country | US
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Telephone | 901-706-7670
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Fax |
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Authorized Official
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Title or Position | FOUNDER & DIRECTOR
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Name | ANIKAY PONTOON
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Credential | CNA
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Telephone | 706-901-7670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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