Provider Demographics
NPI:1285062588
Name:GOLDEN AGE COMPANIONS, LLC
Entity type:Organization
Organization Name:GOLDEN AGE COMPANIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-395-3142
Mailing Address - Street 1:130 LIBERTY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6142
Mailing Address - Country:US
Mailing Address - Phone:949-630-0487
Mailing Address - Fax:
Practice Address - Street 1:130 LIBERTY
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6142
Practice Address - Country:US
Practice Address - Phone:949-630-0487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health