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General NPI Number Information
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NPI Number | 1639625940
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Entity Type | Organization
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Legal Business Name | GOLDEN CARE SERVICES
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 08/27/2016
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Provider Practice Location Address
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Address Line | 532 SETTLERS LANDING RD
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City | HAMPTON
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State | VA
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Zip | 23669-4031
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Country | US
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Telephone | 757-768-6046
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Fax | 866-648-4493
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Provider Business Mailing Address
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Address Line | 532 SETTLERS LANDING RD
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City | HAMPTON
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State | VA
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Zip | 23669-4031
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Country | US
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Telephone | 757-768-6046
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Fax | 866-648-4493
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Authorized Official
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Title or Position | LICENSED ASSISTED LIVING ADMINISTRA
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Name | YANOVA S MITCHENER
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Credential | ADMINISTRATOR
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Telephone | 757-768-6046
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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 | 1104458
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License Number State | VA
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