Provider Demographics
NPI:1780250126
Name:GOLDEN HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:GOLDEN HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PELICAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-625-2163
Mailing Address - Street 1:PO BOX 1424
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:GA
Mailing Address - Zip Code:31305-1424
Mailing Address - Country:US
Mailing Address - Phone:912-625-2163
Mailing Address - Fax:
Practice Address - Street 1:3649 GA HIGHWAY 99 LOT 11
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:GA
Practice Address - Zip Code:31331-8343
Practice Address - Country:US
Practice Address - Phone:912-625-2163
Practice Address - Fax:912-208-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care