Provider Demographics
NPI:1346633922
Name:GOLDEN HEARTS, INC.
Entity Type:Organization
Organization Name:GOLDEN HEARTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-344-2729
Mailing Address - Street 1:6401 BLACKBERRY ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-2135
Mailing Address - Country:US
Mailing Address - Phone:907-344-2729
Mailing Address - Fax:907-677-1105
Practice Address - Street 1:6401 BLACKBERRY ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-2135
Practice Address - Country:US
Practice Address - Phone:907-344-2729
Practice Address - Fax:907-677-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1009163251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1004975Medicaid