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General NPI Number Information
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NPI Number | 1477080224
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Entity Type | Organization
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Legal Business Name | GOLDEN HEART CARE, LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 603 J CLYDE MORRIS BLVD # J SUITE 6
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1826
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Country | US
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Telephone | 757-595-2500
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Fax | 757-595-2513
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Provider Business Mailing Address
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Address Line | 603 J CLYDE MORRIS BLVD # J SUITE 6
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1826
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Country | US
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Telephone | 757-595-2500
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Fax | 757-595-2513
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANITA DANIELLE FRAZIER
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Credential |
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Telephone | 757-778-2652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 037878-2017
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License Number State | VA
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