Provider Demographics
NPI:1306453329
Name:GOLDEN CREEK ENTERPRISES LLC
Entity type:Organization
Organization Name:GOLDEN CREEK ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENYATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-509-3924
Mailing Address - Street 1:13709 SUNSET HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1859
Mailing Address - Country:US
Mailing Address - Phone:281-509-3924
Mailing Address - Fax:
Practice Address - Street 1:13709 SUNSET HARBOR DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1859
Practice Address - Country:US
Practice Address - Phone:281-509-3924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based