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General NPI Number Information
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NPI Number | 1598081903
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Entity Type | Organization
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Legal Business Name | GOLDEN ANGEL HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | 138 SILVER ARROW CIR
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City | AUSTELL
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State | GA
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Zip | 30168-7490
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Country | US
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Telephone | 412-290-5186
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Fax | 770-693-7971
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Provider Business Mailing Address
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Address Line | 138 SILVER ARROW CIR
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City | AUSTELL
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State | GA
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Zip | 30168-7490
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Country | US
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Telephone | 412-290-5186
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Fax | 770-693-7971
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Authorized Official
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Title or Position | CEO
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Name | MISS RICKALE ASHLEY COKLEY
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Credential |
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Telephone | 412-290-5186
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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 | 2010#137111
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License Number State | GA
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