Provider Demographics
NPI:1366613267
Name:GOLDEN LIVING HOMECARE, INC.
Entity type:Organization
Organization Name:GOLDEN LIVING HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:N
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:978-761-8762
Mailing Address - Street 1:3 COURTHOUSE LN UNIT 9
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1721
Mailing Address - Country:US
Mailing Address - Phone:978-710-4232
Mailing Address - Fax:978-710-5697
Practice Address - Street 1:3 COURTHOUSE LN UNIT 9
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1721
Practice Address - Country:US
Practice Address - Phone:978-710-4232
Practice Address - Fax:978-710-4232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN LIVING HOMECARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-18
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110087320AMedicaid
22-7521OtherMEDICARE PTAN (CCN)