Provider Demographics
NPI:1700016052
Name:A HEART OF GOLD HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:A HEART OF GOLD HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:LOYD
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-497-4562
Mailing Address - Street 1:7207 DESIARD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-3914
Mailing Address - Country:US
Mailing Address - Phone:318-497-4562
Mailing Address - Fax:318-938-2270
Practice Address - Street 1:7207 DESIARD ST STE 1
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-3914
Practice Address - Country:US
Practice Address - Phone:318-497-4562
Practice Address - Fax:318-938-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care