Provider Demographics
NPI:1073348942
Name:GOLDEN HOME HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:GOLDEN HOME HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOATENG
Authorized Official - Suffix:
Authorized Official - Credentials:BSC INF TECH
Authorized Official - Phone:703-389-0995
Mailing Address - Street 1:12504 QUARTERHORSE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6370
Mailing Address - Country:US
Mailing Address - Phone:703-389-0995
Mailing Address - Fax:571-412-8069
Practice Address - Street 1:12504 QUARTERHORSE LN
Practice Address - Street 2:
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6370
Practice Address - Country:US
Practice Address - Phone:703-389-0995
Practice Address - Fax:571-412-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health