Provider Demographics
NPI:1336495530
Name:GOLDEN EDGE HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:GOLDEN EDGE HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHINEDUM
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBONNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-994-4173
Mailing Address - Street 1:5630 SPRING VALLEY RD
Mailing Address - Street 2:27A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-3170
Mailing Address - Country:US
Mailing Address - Phone:214-994-4173
Mailing Address - Fax:214-613-8632
Practice Address - Street 1:5630 SPRING VALLEY RD
Practice Address - Street 2:27A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-3170
Practice Address - Country:US
Practice Address - Phone:214-994-4173
Practice Address - Fax:214-613-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health