Provider Demographics
NPI:1285980490
Name:GOLDEN AGE HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:GOLDEN AGE HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORFUI
Authorized Official - Middle Name:DOLLY
Authorized Official - Last Name:KANDEH-DABO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-762-1726
Mailing Address - Street 1:5202 EMORY MILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7120
Mailing Address - Country:US
Mailing Address - Phone:281-762-1726
Mailing Address - Fax:281-762-1727
Practice Address - Street 1:5202 EMORY MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7120
Practice Address - Country:US
Practice Address - Phone:281-762-1726
Practice Address - Fax:281-762-1727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health