MEDICARE: GOLDEN CARES 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	251E00000X	Home Health Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174248017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN CARES LLC

Provider Business Mailing Address
First Line	:	6001 LANDERHAVEN DR STE A2
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-4190
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 LANDERHAVEN DR STE A2
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-4190
Country	:	US
Telephone Number	:	440-459-1233
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	JASMINE SPARKS
Credential	:
Telephone Number	:	216-253-7407

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	10/04/2022

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Directions to “GOLDEN CARES LLC ” Practice Location

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