MEDICARE: GOLDEN AGE COMPANIONS AZ, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1174335038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN AGE COMPANIONS AZ, LLC

Provider Business Mailing Address
First Line	:	16220 N SCOTTSDALE RD STE 3113
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-1781
Country	:	US
Telephone Number	:	480-463-8384
Fax Number	:

Provider Business Practice Location Address
First Line	:	16220 N SCOTTSDALE RD STE 3113
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-1781
Country	:	US
Telephone Number	:	480-463-8384
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. SCOTT MCKENZIE
Credential	:
Telephone Number	:	949-395-3142

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/27/2025

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