Organization
HEART OF GOLD SENIOR SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANN WADE (OWNER/ADMINISTRATOR)
(863) 595-8927
Entity
Organization
Contact information
Practice address
209 FERN RD, WINTER HAVEN, FL 33880-1308
(863) 595-8927
(863) 229-5360
Mailing address
209 FERN RD, WINTER HAVEN, FL 33880-1308
(863) 595-8927
(863) 229-5360
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
233063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009269700
—
FL
Enumeration date
01/08/2014
Last updated
01/08/2014
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