# GOLDEN YEARS ADULT HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154726107
- **Authorized official:** MR. VICTOR ONEIL SMITH (OWNER/CEO/COO)
- **Authorized official phone:** (601) 573-8651

## Contact information

- **Practice address:** 121 COLONIAL GLN, JACKSON, MS 39211-3305
- **Practice address phone:** (601) 573-8651
- **Mailing address:** 121 COLONIAL GLN, JACKSON, MS 39211-3305
- **Mailing address phone:** (601) 573-8651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | MS | — |
| 310400000X | Assisted Living Facility | — | MS | — |
| 372600000X | Adult Companion | — | MS | Yes |

## Other

- **Enumeration date:** 11/01/2014
- **Last updated:** 11/01/2014