Provider Demographics
NPI:1952402166
Name:GOLDEN ACRES HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:GOLDEN ACRES HEALTHCARE SERVICES, INC
Other - Org Name:GOLDEN ACRES HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-962-4948
Mailing Address - Street 1:6430 RICHMOND AVE.
Mailing Address - Street 2:STE 130
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057
Mailing Address - Country:US
Mailing Address - Phone:832-962-4948
Mailing Address - Fax:832-962-4950
Practice Address - Street 1:6430 RICHMOND AVE
Practice Address - Street 2:STE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057
Practice Address - Country:US
Practice Address - Phone:832-962-4948
Practice Address - Fax:832-962-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011004251E00000X
TX74-7083251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-7083Medicare UPIN
TX747083Medicare Oscar/Certification