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General NPI Number Information
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NPI Number | 1508563958
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Entity Type | Organization
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Legal Business Name | GOLDEN GIRLS OF LLA
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 55 MEADOWGATE BLVD
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City | BEDFORD
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State | OH
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Zip | 44146-2209
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Country | US
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Telephone | 216-510-6777
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Fax | 216-510-6777
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Provider Business Mailing Address
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Address Line | 55 MEADOWGATE BLVD
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City | BEDFORD
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State | OH
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Zip | 44146-2209
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Country | US
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Telephone | 216-510-6777
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Fax | 216-510-6777
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Authorized Official
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Title or Position | PRESIDENT
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Name | LATINA MILLS
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Credential | NRCMA STNA
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Telephone | 216-990-6928
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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 |
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License Number State |
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