MEDICARE: GOLDEN HORIZONS ADC

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	261QA0600X	Adult Day Care Clinic/Center	06212019	NC

General Provider Information

NPI Number	:	1558847848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HORIZONS ADC

Provider Business Mailing Address
First Line	:	1916 MEETING ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-3058
Country	:	US
Telephone Number	:	919-451-3776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1106 SUITE C HILLANDALE RD.
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-2770
Country	:	US
Telephone Number	:	919-286-4489
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. DOUGLAS VAN COLEMAN
Credential	:
Telephone Number	:	919-286-4489

Provider Enumeration Date	:	07/19/2018
Last Update Date	:	07/19/2018

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