Provider Demographics
NPI:1851761571
Name:GOLDEN HEART HEALTH SERVICES
Entity Type:Organization
Organization Name:GOLDEN HEART HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, MBA
Authorized Official - Phone:317-871-2711
Mailing Address - Street 1:7770 MICHIGAN RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-2375
Mailing Address - Country:US
Mailing Address - Phone:317-871-2711
Mailing Address - Fax:317-871-2714
Practice Address - Street 1:7770 MICHIGAN RD
Practice Address - Street 2:SUITE D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2375
Practice Address - Country:US
Practice Address - Phone:317-871-2711
Practice Address - Fax:317-871-2714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health