Provider Demographics
NPI:1336681857
Name:GOLDEN AGE HOME HEALTH CORP
Entity Type:Organization
Organization Name:GOLDEN AGE HOME HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:STURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-501-7727
Mailing Address - Street 1:1117 W PIONEER PKWY STE 100B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6398
Mailing Address - Country:US
Mailing Address - Phone:817-617-8016
Mailing Address - Fax:817-459-3314
Practice Address - Street 1:1117 W PIONEER PKWY STE 100B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6398
Practice Address - Country:US
Practice Address - Phone:817-617-8016
Practice Address - Fax:817-459-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care