Provider Demographics
NPI:1326187071
Name:GOLDEN AGE CARE, LLC
Entity type:Organization
Organization Name:GOLDEN AGE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-583-9999
Mailing Address - Street 1:209 COMMERCIAL COURT
Mailing Address - Street 2:ATTEN: CYNTHIA CHEVAL -ADMINISTRATOR
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1061
Mailing Address - Country:US
Mailing Address - Phone:732-583-9999
Mailing Address - Fax:732-583-3883
Practice Address - Street 1:209 COMMERCIAL COURT
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1061
Practice Address - Country:US
Practice Address - Phone:732-583-9999
Practice Address - Fax:732-583-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0044831Medicaid