Provider Demographics
NPI:1235954447
Name:LIFE IS GOLDEN HOMECARE
Entity type:Organization
Organization Name:LIFE IS GOLDEN HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALESTIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-693-1786
Mailing Address - Street 1:123 S BROAD ST STE 1500
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19109-1029
Mailing Address - Country:US
Mailing Address - Phone:267-693-1786
Mailing Address - Fax:
Practice Address - Street 1:123 S BROAD ST STE 1500
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19109-1029
Practice Address - Country:US
Practice Address - Phone:267-693-1786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health