Provider Demographics
NPI:1477974707
Name:GOLDEN AGE HOME HEALTH LLC
Entity Type:Organization
Organization Name:GOLDEN AGE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:THUKU
Authorized Official - Last Name:KAMAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-853-3797
Mailing Address - Street 1:329 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2162
Mailing Address - Country:US
Mailing Address - Phone:508-853-3797
Mailing Address - Fax:
Practice Address - Street 1:329 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2162
Practice Address - Country:US
Practice Address - Phone:508-853-3797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health