Provider Demographics
NPI:1578854014
Name:GOLDEN OPPORTUNITIES
Entity Type:Organization
Organization Name:GOLDEN OPPORTUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-629-3163
Mailing Address - Street 1:4901 SW 109TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-7742
Mailing Address - Country:US
Mailing Address - Phone:352-629-3163
Mailing Address - Fax:352-629-1505
Practice Address - Street 1:4901 SW 109TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-7742
Practice Address - Country:US
Practice Address - Phone:352-629-3163
Practice Address - Fax:352-629-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-01
Last Update Date:2011-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL688759796251C00000X
FL688759798251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688759798Medicaid
FL688759796Medicaid