MEDICARE: GOLDEN TOUCH HEALTHCARE 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1881045706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN TOUCH HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	7618 HICKMAN RD
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-4510
Country	:	US
Telephone Number	:	319-427-3282
Fax Number	:	515-575-9650

Provider Business Practice Location Address
First Line	:	7618 HICKMAN RD
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-4510
Country	:	US
Telephone Number	:	319-427-3282
Fax Number	:	515-575-9650

Authorized Official
Title or Position	:	COO
Name	:	FODAY KARGBO
Credential	:
Telephone Number	:	319-427-3282

Provider Enumeration Date	:	06/22/2016
Last Update Date	:	06/22/2016

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