Provider Demographics
NPI:1639735202
Name:GOLDEN AGES PALLIATIVE AND HOSPICE CARE INC.
Entity Type:Organization
Organization Name:GOLDEN AGES PALLIATIVE AND HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARAVILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-202-9870
Mailing Address - Street 1:44140 20TH ST W STE 103
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4045
Mailing Address - Country:US
Mailing Address - Phone:166-120-2987
Mailing Address - Fax:661-526-5243
Practice Address - Street 1:44140 20TH ST W STE 103
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4045
Practice Address - Country:US
Practice Address - Phone:661-202-9870
Practice Address - Fax:661-522-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-19
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based