Provider Demographics
NPI:1386147726
Name:GOLDEN VISTA HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GOLDEN VISTA HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIELLE TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:GO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-467-9038
Mailing Address - Street 1:5890 S DURANGO DR STE 100B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2319
Mailing Address - Country:US
Mailing Address - Phone:702-268-8615
Mailing Address - Fax:702-665-6525
Practice Address - Street 1:5890 S DURANGO DR STE 100B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2319
Practice Address - Country:US
Practice Address - Phone:702-268-8615
Practice Address - Fax:702-665-6525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health