Provider Demographics
NPI:1417785726
Name:GOLDEN CROWN HOME CARE LLC
Entity type:Organization
Organization Name:GOLDEN CROWN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOLENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-829-3010
Mailing Address - Street 1:2601 N FRONT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1123
Mailing Address - Country:US
Mailing Address - Phone:717-829-3010
Mailing Address - Fax:
Practice Address - Street 1:2601 N FRONT ST STE 103
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1123
Practice Address - Country:US
Practice Address - Phone:717-829-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health