Provider Demographics
NPI:1659905040
Name:GOLDEN HEART HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:GOLDEN HEART HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:K
Authorized Official - Last Name:GRATTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-820-0871
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-0586
Mailing Address - Country:US
Mailing Address - Phone:218-820-0871
Mailing Address - Fax:
Practice Address - Street 1:601 MADISON ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-4518
Practice Address - Country:US
Practice Address - Phone:218-820-0871
Practice Address - Fax:218-270-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health