Provider Demographics
NPI:1891365417
Name:GOLDEN YEARS CONCIERGE SERVICE, LLC
Entity Type:Organization
Organization Name:GOLDEN YEARS CONCIERGE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARFULAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-921-4767
Mailing Address - Street 1:5231 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-3208
Mailing Address - Country:US
Mailing Address - Phone:267-469-4803
Mailing Address - Fax:877-397-2559
Practice Address - Street 1:2449 GOLF RD STE 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1475
Practice Address - Country:US
Practice Address - Phone:215-921-4767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care