Provider Demographics
NPI:1437727849
Name:GOLDEN CARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:GOLDEN CARE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF AMDINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:GYJUANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TWYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ASN MA
Authorized Official - Phone:317-802-7616
Mailing Address - Street 1:3905 VINCENNES RD STE 120
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3055
Mailing Address - Country:US
Mailing Address - Phone:317-802-7616
Mailing Address - Fax:317-552-2090
Practice Address - Street 1:3905 VINCENNES RD STE 120
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3055
Practice Address - Country:US
Practice Address - Phone:317-802-7616
Practice Address - Fax:317-552-2090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN20-015028OtherSTATE LICENSE