Provider Demographics
NPI:1669263703
Name:GOLDEN YEARS LLC
Entity type:Organization
Organization Name:GOLDEN YEARS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-300-3803
Mailing Address - Street 1:10099 CASTLEBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-0081
Mailing Address - Country:US
Mailing Address - Phone:704-300-3803
Mailing Address - Fax:704-300-3803
Practice Address - Street 1:1933 JAKE ALEXANDER BLVD W STE 103
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1157
Practice Address - Country:US
Practice Address - Phone:980-866-3188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty