Provider Demographics
NPI:1316168495
Name:GOLDEN CARE II
Entity type:Organization
Organization Name:GOLDEN CARE II
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-529-0161
Mailing Address - Street 1:5115 SHERRER DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-2465
Mailing Address - Country:US
Mailing Address - Phone:770-529-0161
Mailing Address - Fax:770-529-9954
Practice Address - Street 1:5115 SHERRER DR NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-2465
Practice Address - Country:US
Practice Address - Phone:770-529-0161
Practice Address - Fax:770-529-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health