Provider Demographics
NPI:1982845541
Name:GOLDEN GATES HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:GOLDEN GATES HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-572-7193
Mailing Address - Street 1:PO BOX 83135
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-3135
Mailing Address - Country:US
Mailing Address - Phone:225-218-6819
Mailing Address - Fax:225-218-6842
Practice Address - Street 1:1713 WOODDALE BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1570
Practice Address - Country:US
Practice Address - Phone:225-218-6819
Practice Address - Fax:225-218-6842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA151863747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty