Provider Demographics
NPI:1568233823
Name:GOLDEN YEARS CENTER INC
Entity Type:Organization
Organization Name:GOLDEN YEARS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABRIYE
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-787-5053
Mailing Address - Street 1:2400 W 66TH ST SUITE 130
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2068
Mailing Address - Country:US
Mailing Address - Phone:612-787-5053
Mailing Address - Fax:
Practice Address - Street 1:2400 W 66TH ST SUITE 130
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55423-2068
Practice Address - Country:US
Practice Address - Phone:612-787-5053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)