Provider Demographics
NPI:1215425889
Name:GOLDEN HEARTS OF OC, LLC
Entity type:Organization
Organization Name:GOLDEN HEARTS OF OC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-899-5582
Mailing Address - Street 1:70 SKLAR ST APT 1401
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-0783
Mailing Address - Country:US
Mailing Address - Phone:949-899-5582
Mailing Address - Fax:
Practice Address - Street 1:70 SKLAR ST APT 1401
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-0783
Practice Address - Country:US
Practice Address - Phone:949-899-5582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA304700155OtherSTATE OF CALIFORNIA - DEPT OF SOCIAL SERVICES