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General NPI Number Information
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NPI Number | 1851708713
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Entity Type | Organization
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Legal Business Name | GOLDEN AGE DAY CARE SERVICE
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 464 INDUSTRIAL MILE RD
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City | COLUMBUS
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State | OH
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Zip | 43228-2411
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Country | US
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Telephone | 614-351-8351
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Fax |
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Provider Business Mailing Address
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Address Line | 464 INDUSTRIAL MILE RD
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City | COLUMBUS
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State | OH
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Zip | 43228-2411
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Country | US
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Telephone | 614-351-8351
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MOHAMED DALLIN
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Credential |
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Telephone | 614-351-8351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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