MEDICARE: GOLDEN HOUR AESTHETICS FOUNDATION INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	251S00000X	Community/Behavioral Health Agency
3	261QC1500X	Community Health Clinic/Center
4	251E00000X	Home Health Agency
5	103K00000X	Behavior Analyst
6	390200000X	Student in an Organized Health Care Education/Training Program
7	171M00000X	Case Manager/Care Coordinator
8	171W00000X	Contractor
9	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1417883513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HOUR AESTHETICS FOUNDATION INC

Provider Business Mailing Address
First Line	:	2038 DEFOORS XING NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2038 DEFOORS XING NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2337
Country	:	US
Telephone Number	:	573-270-2129
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GABRIELLE ROGERS
Credential	:
Telephone Number	:	573-270-2129

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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