Provider Demographics
NPI:1598351918
Name:GOLD HEART ENTERPRISE LLC
Entity Type:Organization
Organization Name:GOLD HEART ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZILLEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OZUAGIEMHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-888-0183
Mailing Address - Street 1:2060 CONTINENTAL AVE APT 263
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-1715
Mailing Address - Country:US
Mailing Address - Phone:850-888-0183
Mailing Address - Fax:
Practice Address - Street 1:2060 CONTINENTAL AVE APT 263
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1715
Practice Address - Country:US
Practice Address - Phone:850-888-0183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty