Provider Demographics
NPI:1093782260
Name:GOLDEN HEALTH SERVICES INC
Entity Type:Organization
Organization Name:GOLDEN HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FOLASADE
Authorized Official - Middle Name:O
Authorized Official - Last Name:AJIBOLADE
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSC
Authorized Official - Phone:215-289-9005
Mailing Address - Street 1:2100 SCATTERGOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-2012
Mailing Address - Country:US
Mailing Address - Phone:215-289-9005
Mailing Address - Fax:215-289-9024
Practice Address - Street 1:2100 SCATTERGOOD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-2012
Practice Address - Country:US
Practice Address - Phone:215-289-9005
Practice Address - Fax:215-289-9024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA77970501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009181050001Medicaid
PA1009181050004Medicaid
PA1009181050001Medicaid