Provider Demographics
NPI:1235715103
Name:SONYA L GOLDEN
Entity Type:Organization
Organization Name:SONYA L GOLDEN
Other - Org Name:NGOZI PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-563-9068
Mailing Address - Street 1:7951 CHARLESTOWN LN
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-8642
Mailing Address - Country:US
Mailing Address - Phone:469-563-9068
Mailing Address - Fax:
Practice Address - Street 1:7951 CHARLESTOWN LN
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-8642
Practice Address - Country:US
Practice Address - Phone:469-563-9068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities