Provider Demographics
NPI:1255426250
Name:GOLDEN HOUR SR CENTER
Entity type:Organization
Organization Name:GOLDEN HOUR SR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR GOLDEN HOUR SR CENTER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MAKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-872-3223
Mailing Address - Street 1:550 UINTA DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-5005
Mailing Address - Country:US
Mailing Address - Phone:307-872-3223
Mailing Address - Fax:307-872-3225
Practice Address - Street 1:550 UINTA DR
Practice Address - Street 2:SUITE A
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5005
Practice Address - Country:US
Practice Address - Phone:307-872-3223
Practice Address - Fax:307-872-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals