MEDICARE: GOLDEN HOME CARE AGENCY INC

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

General Provider Information

NPI Number	:	1295369460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HOME CARE AGENCY INC

Provider Business Mailing Address
First Line	:	1230 S PARKER RD STE 205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2119
Country	:	US
Telephone Number	:	303-520-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 S PARKER RD STE 205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2119
Country	:	US
Telephone Number	:	303-520-3500
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	INNA CAPUSTA
Credential	:
Telephone Number	:	303-520-3500

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	02/26/2020

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