MEDICARE: GOLDEN LIFE 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1346182169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN LIFE LLC

Provider Business Mailing Address
First Line	:	6901 TWIN PONDS DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-8770
Country	:	US
Telephone Number	:	205-910-6515
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 TWIN PONDS DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-8770
Country	:	US
Telephone Number	:	205-910-6515
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GINI HEDER MOHAMMED
Credential	:
Telephone Number	:	205-910-6515

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “GOLDEN LIFE LLC ” Practice Location

Language	Start Address	Practice Location

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