Organization
GOLDEN CARE SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMED FOFANAH MPH (PRESIDENT)
(614) 929-1931
Entity
Organization
Contact information
Practice address
5530 99TH ST APT 3K, CORONA, NY 11368-3735
(347) 579-6274
Mailing address
5530 99TH ST APT 3K, CORONA, NY 11368-3735
(347) 579-6274
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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