# GOLD STREET CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Seniority Lifecare at Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972879021
- **Authorized official:** MR. IRA J USLANDER (GENERAL MANAGER)
- **Authorized official phone:** (209) 532-4500

## Contact information

- **Practice address:** 11 S WASHINGTON ST STE 200, SONORA, CA 95370-4717
- **Practice address phone:** (209) 532-4500
- **Practice address fax:** (209) 532-4505
- **Mailing address:** 11 S WASHINGTON ST STE 200, SONORA, CA 95370-4717
- **Mailing address phone:** (209) 532-4500
- **Mailing address fax:** (209) 532-4505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/22/2012
- **Last updated:** 03/22/2012