Provider Demographics
NPI:1437811130
Name:GOLDEN CARE AGENCY LLC
Entity Type:Organization
Organization Name:GOLDEN CARE AGENCY LLC
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU-GYAMFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-605-0316
Mailing Address - Street 1:6316 PHYLLIS LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-6402
Mailing Address - Country:US
Mailing Address - Phone:301-605-0316
Mailing Address - Fax:
Practice Address - Street 1:15190 LEICESTERSHIRE ST UNIT 331
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-5938
Practice Address - Country:US
Practice Address - Phone:301-605-0316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-10
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services