Provider Demographics
NPI:1740566108
Name:GOLDEN AGE HOME HEALTH AGENCY, CORP
Entity Type:Organization
Organization Name:GOLDEN AGE HOME HEALTH AGENCY, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAIDA
Authorized Official - Middle Name:LIS
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-447-6491
Mailing Address - Street 1:7370 COLLEGE PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5501
Mailing Address - Country:US
Mailing Address - Phone:239-325-8586
Mailing Address - Fax:239-236-7287
Practice Address - Street 1:7370 COLLEGE PKWY STE 305
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5501
Practice Address - Country:US
Practice Address - Phone:239-325-8586
Practice Address - Fax:239-236-7287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health