Provider Demographics
NPI:1558847848
Name:GOLDEN HORIZONS ADC
Entity Type:Organization
Organization Name:GOLDEN HORIZONS ADC
Other - Org Name:GOLDEN HORIZONS ADC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-286-4489
Mailing Address - Street 1:1916 MEETING ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3058
Mailing Address - Country:US
Mailing Address - Phone:919-451-3776
Mailing Address - Fax:
Practice Address - Street 1:1106 SUITE C HILLANDALE RD.
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2770
Practice Address - Country:US
Practice Address - Phone:919-286-4489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06212019261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care