Provider Demographics
NPI:1144206756
Name:JCH INC DBA GOLDEN SERVICES HOME HEALTH AND HOSPICE
Entity Type:Organization
Organization Name:JCH INC DBA GOLDEN SERVICES HOME HEALTH AND HOSPICE
Other - Org Name:GOLDEN SERVICES LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIEBERWIRTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-885-3082
Mailing Address - Street 1:800 W PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5200
Mailing Address - Country:US
Mailing Address - Phone:575-885-3082
Mailing Address - Fax:575-885-5331
Practice Address - Street 1:800 W PIERCE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5200
Practice Address - Country:US
Practice Address - Phone:575-885-3082
Practice Address - Fax:575-885-5331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN1797Medicaid
NMN1797Medicaid