Provider Demographics
NPI:1962195065
Name:A3 GOLDEN HOME CARE LLC
Entity type:Organization
Organization Name:A3 GOLDEN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANWARA
Authorized Official - Middle Name:AWENI
Authorized Official - Last Name:ADJASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-425-2620
Mailing Address - Street 1:5003 ELIOT PL
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-1790
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5003 ELIOT PL
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-1790
Practice Address - Country:US
Practice Address - Phone:331-425-2620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health