Provider Demographics
NPI:1962714691
Name:GOLDEN LIFE INC
Entity type:Organization
Organization Name:GOLDEN LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PRIMUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ODILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-367-3899
Mailing Address - Street 1:1218 MURFREESBORO RD STE 112
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2440
Mailing Address - Country:US
Mailing Address - Phone:615-367-3899
Mailing Address - Fax:615-367-3896
Practice Address - Street 1:1218 MURFREESBORO ROAD SUITE 112
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217
Practice Address - Country:US
Practice Address - Phone:615-367-3899
Practice Address - Fax:615-367-3896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000005635251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health