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NPI 1780250126

NPI 1780250126 : GOLDEN HOME CARE SERVICES LLC : TOWNSEND, GA

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General NPI Number Information
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    NPI Number           |    1780250126
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    Entity Type          |    Organization 
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    Legal Business Name  |    GOLDEN HOME CARE SERVICES LLC 
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Dates
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    Enumeration Date     |    05/27/2021
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    Last Update Date     |    12/30/2021
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Provider Practice Location Address
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    Address Line         |    3649 GA HIGHWAY 99 LOT 11 
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    City                 |    TOWNSEND
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    State                |    GA
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    Zip                  |    31331-8343
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    Country              |    US
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    Telephone            |    912-625-2163
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    Fax                  |    912-208-7057
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1424 
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    City                 |    DARIEN
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    State                |    GA
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    Zip                  |    31305-1424
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    Country              |    US
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    Telephone            |    912-625-2163
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     YOLANDA NICOLE PELICAN 
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    Credential           |    
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    Telephone            |    912-625-2163
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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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Taxonomy #2
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    385H00000X
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    Taxonomy Name        |    Respite Care
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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