Organization
A GOLDEN EXPERIENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAQUANDA SPINCE NP (OWNER/NURSE PRACTITIONER)
(770) 386-7927
Entity
Organization
Contact information
Practice address
3200 N HENRY BLVD STE C, STOCKBRIDGE, GA 30281-4666
(770) 376-6927
(770) 727-7024
Mailing address
3200 N HENRY BLVD STE C, STOCKBRIDGE, GA 30281-4666
(770) 376-6927
(770) 727-7024
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003240710A
—
GA
Enumeration date
08/12/2022
Last updated
08/12/2022
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