MEDICARE: GOLDENPATH HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1073445581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDENPATH HOMECARE LLC

Provider Business Mailing Address
First Line	:	3427 LANGLEY BEND LN
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-2639
Country	:	US
Telephone Number	:	832-757-6771
Fax Number	:

Provider Business Practice Location Address
First Line	:	3427 LANGLEY BEND LN
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-2639
Country	:	US
Telephone Number	:	832-202-4359
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	MR. OLUSOLA AJAYI
Credential	:	MD
Telephone Number	:	832-202-4359

Provider Enumeration Date	:	05/30/2026
Last Update Date	:	05/30/2026

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