Organization
GOLDEN HEALTHCARE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EKAN EKONG NURSE PRACTITIONER (MEDICAL DIRECTOR)
(763) 498-4448
Entity
Organization
Contact information
Practice address
2579 CHARLOTTE ST, ROSEVILLE, MN 55113-2808
(763) 498-4448
Mailing address
2579 CHARLOTTE ST, ROSEVILLE, MN 55113-2808
(763) 498-4448
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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