Provider Demographics
NPI:1134845696
Name:GOLDEN TOUCH ANGELS
Entity type:Organization
Organization Name:GOLDEN TOUCH ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCLAURIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-344-7801
Mailing Address - Street 1:1104 W 1ST ST STE 6
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4357
Mailing Address - Country:US
Mailing Address - Phone:601-344-7801
Mailing Address - Fax:601-342-2766
Practice Address - Street 1:1104 W 1ST ST STE 6
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4357
Practice Address - Country:US
Practice Address - Phone:601-344-7801
Practice Address - Fax:601-342-2766
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN TOUCH HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08137540Medicaid