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General NPI Number Information
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NPI Number | 1548326671
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Entity Type | Organization
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Legal Business Name | GOLDEN PERSONAL CARE HOME, INC.
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 257 GOLDEN RD
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City | EASTMAN
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State | GA
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Zip | 31023-3929
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Country | US
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Telephone | 478-374-2483
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Fax | 478-374-7410
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Provider Business Mailing Address
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Address Line | 257 GOLDEN RD
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City | EASTMAN
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State | GA
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Zip | 31023-3929
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Country | US
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Telephone | 478-374-2483
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Fax | 478-374-7410
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. JAN GOLDEN SMITH
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Credential | RN
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Telephone | 478-374-2483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | GA
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