Provider Demographics
NPI:1376016956
Name:GOLDEN CARE PARTNERS, INC.
Entity Type:Organization
Organization Name:GOLDEN CARE PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER-CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GOLDEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-980-5153
Mailing Address - Street 1:17220 N BOSWELL BLVD STE 123W
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373-1985
Mailing Address - Country:US
Mailing Address - Phone:623-980-5153
Mailing Address - Fax:623-748-3144
Practice Address - Street 1:17220 N BOSWELL BLVD STE 123W
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85373-1985
Practice Address - Country:US
Practice Address - Phone:623-980-5153
Practice Address - Fax:623-748-3144
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN HEART SENIOR CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ612121OtherARIZONA HEALTHCARE COST CONTAINMENT SYSTEM
AZA05990715Medicaid