Provider Demographics
NPI:1245909290
Name:GOOD OLE HEALTHCARE LLC
Entity type:Organization
Organization Name:GOOD OLE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIASHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DENBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-261-0640
Mailing Address - Street 1:477 BEAVER ST APT G12
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2029
Mailing Address - Country:US
Mailing Address - Phone:475-261-0640
Mailing Address - Fax:
Practice Address - Street 1:477 BEAVER ST APT G12
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2029
Practice Address - Country:US
Practice Address - Phone:475-261-0640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-12
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health