Organization
GOLDEN LITTLE STAR CHILD CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB JORDAN (CEO/OWNER)
(304) 888-9430
Entity
Organization
Contact information
Practice address
1089 GAITHER PL NW, CONCORD, NC 28027-6067
(304) 888-9430
Mailing address
1089 GAITHER PL NW, CONCORD, NC 28027-6067
(304) 888-9430
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM3000X
Medically Fragile Infants and Children Day Care
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
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