Provider Demographics
NPI:1558772210
Name:GOLDEN YEARS IN HOME CARE LLC
Entity Type:Organization
Organization Name:GOLDEN YEARS IN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-650-4531
Mailing Address - Street 1:34542 CLINTON PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-3352
Mailing Address - Country:US
Mailing Address - Phone:903-650-4531
Mailing Address - Fax:
Practice Address - Street 1:34542 CLINTON PLAZA DR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-3352
Practice Address - Country:US
Practice Address - Phone:903-650-4531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health