Provider Demographics
NPI:1770238073
Name:GOLDEN CIRCLE COMPREHENSIVE SERVICES LLC
Entity Type:Organization
Organization Name:GOLDEN CIRCLE COMPREHENSIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DM
Authorized Official - Phone:706-945-8617
Mailing Address - Street 1:2801 WASHINGTON RD STE 107
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2355
Mailing Address - Country:US
Mailing Address - Phone:706-945-8617
Mailing Address - Fax:
Practice Address - Street 1:516 FORT AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-7214
Practice Address - Country:US
Practice Address - Phone:706-945-8617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care