Provider Demographics
NPI:1942053103
Name:GOLDEN GROUP HOME HEALTH LLC
Entity Type:Organization
Organization Name:GOLDEN GROUP HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:YADISON
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-322-9323
Mailing Address - Street 1:6625 MIAMI LAKES DR E STE 228
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2761
Mailing Address - Country:US
Mailing Address - Phone:786-322-9323
Mailing Address - Fax:786-598-8017
Practice Address - Street 1:6625 MIAMI LAKES DR E STE 228
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2761
Practice Address - Country:US
Practice Address - Phone:786-322-9323
Practice Address - Fax:786-598-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty