Organization
MY GOLDEN AGE MGT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYERLIN ANGULO CBHT (PRESIDENT)
(786) 608-2876
Entity
Organization
Contact information
Practice address
6825 JIMMY CARTER BLVD STE 1700, NORCROSS, GA 30071-1269
(786) 608-2876
Mailing address
6825 JIMMY CARTER BLVD STE 1700, NORCROSS, GA 30071-1269
(786) 608-2876
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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