Provider Demographics
NPI:1427872209
Name:GOLDEN LIVING HOMECARE LLC
Entity type:Organization
Organization Name:GOLDEN LIVING HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MONMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-291-3794
Mailing Address - Street 1:720 S PARK PL
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-5832
Mailing Address - Country:US
Mailing Address - Phone:763-291-3794
Mailing Address - Fax:
Practice Address - Street 1:720 S PARK PL
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-5832
Practice Address - Country:US
Practice Address - Phone:763-291-3794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care