Provider Demographics
NPI:1407481385
Name:GOLDEN BRIGHT HOMES LLC
Entity Type:Organization
Organization Name:GOLDEN BRIGHT HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARHIA
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:SIAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-732-2269
Mailing Address - Street 1:2842 RALEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1967
Mailing Address - Country:US
Mailing Address - Phone:763-732-2269
Mailing Address - Fax:
Practice Address - Street 1:2842 RALEIGH AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1967
Practice Address - Country:US
Practice Address - Phone:763-732-2269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)