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General NPI Number Information
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NPI Number | 1710578869
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Entity Type | Organization
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Legal Business Name | THE GOLDEN CENTER LLC
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 4112 WESTMORLAND CIR
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City | FREDERICKSBURG
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State | VA
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Zip | 22408
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Country | US
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Telephone | 175-760-2643
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Fax | 757-299-1171
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Provider Business Mailing Address
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Address Line | 4112 WESTMORLAND CIR APT 221
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City | FREDERICKSBURG
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State | VA
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Zip | 22408
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Country | US
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Telephone | 175-760-2643
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Fax | 757-299-1171
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Authorized Official
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Title or Position | CEO
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Name | ASHLEY GOLDEN
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Credential | M.ED, B.S
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Telephone | 757-943-4378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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