Organization
A GOLDEN LIFE PERSONAL CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENA GOLDEN (DIRECTOR)
(877) 430-3828
Entity
Organization
Contact information
Practice address
3153 DOVE CT, B, SNELLVILLE, GA 30078-3652
(877) 430-3828
(404) 220-8856
Mailing address
3153 DOVE CT, B, SNELLVILLE, GA 30078-3652
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504647604K
—
GA
05
—
504647604L
—
GA
05
—
504647604M
—
GA
05
—
504647604O
—
GA
05
—
507647604B
—
GA
05
—
507647604C
—
GA
05
—
507647604E
—
GA
05
—
507647604F
—
GA
05
—
507647604G
—
GA
05
—
507647604H
—
GA
05
—
507647604I
—
GA
05
—
507647604J
—
GA
05
—
507647604N
—
GA
Enumeration date
02/28/2013
Last updated
02/28/2013
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