Provider Demographics
NPI:1114638491
Name:GOLDEN RULE CARE PROVIDER, LLC
Entity Type:Organization
Organization Name:GOLDEN RULE CARE PROVIDER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MORAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-623-4100
Mailing Address - Street 1:PO BOX 1286
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-1286
Mailing Address - Country:US
Mailing Address - Phone:337-332-4005
Mailing Address - Fax:337-332-6671
Practice Address - Street 1:2214 GRAND POINT RD
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-3322
Practice Address - Country:US
Practice Address - Phone:337-332-4005
Practice Address - Fax:337-332-6671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2583077Medicaid