Provider Demographics
NPI:1619435195
Name:THE GOLDEN YEARS ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:THE GOLDEN YEARS ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATURINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-639-9296
Mailing Address - Street 1:140 GREENFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-1148
Mailing Address - Country:US
Mailing Address - Phone:770-639-9296
Mailing Address - Fax:
Practice Address - Street 1:140 GREENFIELD WAY
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-1148
Practice Address - Country:US
Practice Address - Phone:770-639-9296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care