Provider Demographics
NPI:1881468742
Name:HEART OF GOLD NURSING
Entity type:Organization
Organization Name:HEART OF GOLD NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-679-3355
Mailing Address - Street 1:41995 BOARDWALK STE J
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-9065
Mailing Address - Country:US
Mailing Address - Phone:760-679-3355
Mailing Address - Fax:
Practice Address - Street 1:74399 HIGHWAY 111 STE D
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4128
Practice Address - Country:US
Practice Address - Phone:760-679-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care