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Organization
GOLDEN GIRLS OF LLA
Active
Organization
GOLDEN GIRLS OF LLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATINA MILLS NRCMA STNA (PRESIDENT)
(216) 990-6928
Entity
Organization
Contact information
Practice address
55 MEADOWGATE BLVD, BEDFORD, OH 44146-2209
(216) 510-6777
(216) 510-6777
Mailing address
55 MEADOWGATE BLVD, BEDFORD, OH 44146-2209
(216) 510-6777
(216) 510-6777
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-8252
LICENSE TO OPERATE A RESIDENTIAL FACILITY
OH
01
—
184945
NRCMA
OH
01
—
415856
DODD
OH
01
—
602333940421
STATE TESTED NURSE ASSISTANT
OH
Enumeration date
02/15/2023
Last updated
02/15/2023
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