Provider Demographics
NPI:1568969764
Name:GOLDEN HOME CARE SERVICE LLC
Entity Type:Organization
Organization Name:GOLDEN HOME CARE SERVICE LLC
Other - Org Name:GOLDEN HOME CARE SERVICE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-355-8663
Mailing Address - Street 1:2100 W 76TH ST STE 211
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5503
Mailing Address - Country:US
Mailing Address - Phone:786-355-8663
Mailing Address - Fax:
Practice Address - Street 1:2100 W 76TH ST STE 211
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5503
Practice Address - Country:US
Practice Address - Phone:786-355-8663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
30211963251E00000X
FL30211963253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care