Provider Demographics
NPI:1467113159
Name:GOLDENCARE HOME SERVICES, LLC
Entity Type:Organization
Organization Name:GOLDENCARE HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-943-3032
Mailing Address - Street 1:3904 JOHNS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27249-9626
Mailing Address - Country:US
Mailing Address - Phone:919-943-3032
Mailing Address - Fax:
Practice Address - Street 1:3904 JOHNS CREEK DR
Practice Address - Street 2:
Practice Address - City:GIBSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27249-9626
Practice Address - Country:US
Practice Address - Phone:919-943-3032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health