Provider Demographics
NPI:1780229294
Name:GOLDEN YEARS HOME CARE SOLUTIONS
Entity Type:Organization
Organization Name:GOLDEN YEARS HOME CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-236-7310
Mailing Address - Street 1:9126 ELK GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2013
Mailing Address - Country:US
Mailing Address - Phone:916-333-0383
Mailing Address - Fax:916-244-9898
Practice Address - Street 1:9126 ELK GROVE BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2013
Practice Address - Country:US
Practice Address - Phone:916-333-0383
Practice Address - Fax:916-244-9898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA344700040OtherHOME CARE ORGANIZATION