Provider Demographics
NPI:1407661531
Name:GOLDEN ANGELS HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:GOLDEN ANGELS HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHALMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:601-710-6273
Mailing Address - Street 1:2518 SELLERS DR STE 5
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-1722
Mailing Address - Country:US
Mailing Address - Phone:601-994-1112
Mailing Address - Fax:833-466-1923
Practice Address - Street 1:2518 SELLERS DR STE 5
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-1722
Practice Address - Country:US
Practice Address - Phone:601-994-1112
Practice Address - Fax:833-466-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care