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General NPI Number Information
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NPI Number | 1831897214
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Entity Type | Organization
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Legal Business Name | GOLDEN HORIZON RESPITE CARE LLC
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 2711 EXCHANGE CT STE A-1
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-4017
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Country | US
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Telephone | 561-908-1291
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Fax | 561-328-7931
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Provider Business Mailing Address
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Address Line | 2711 EXCHANGE CT STE A-1
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-4017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | PETROS KOURACLES
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Credential |
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Telephone | 561-908-1291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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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 | 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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