Provider Demographics
NPI:1750080883
Name:GOLDEN CARE
Entity type:Organization
Organization Name:GOLDEN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-472-4400
Mailing Address - Street 1:4142 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55384-9629
Mailing Address - Country:US
Mailing Address - Phone:612-470-4400
Mailing Address - Fax:
Practice Address - Street 1:4142 SHORELINE DR
Practice Address - Street 2:
Practice Address - City:SPRING PARK
Practice Address - State:MN
Practice Address - Zip Code:55384-9629
Practice Address - Country:US
Practice Address - Phone:612-470-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care