Provider Demographics
NPI:1609752930
Name:GOLDENOAK LIVING, LLC
Entity type:Organization
Organization Name:GOLDENOAK LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKECIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-758-0966
Mailing Address - Street 1:206 STANSBURY WAY
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-3327
Mailing Address - Country:US
Mailing Address - Phone:478-758-0966
Mailing Address - Fax:
Practice Address - Street 1:206 STANSBURY WAY
Practice Address - Street 2:
Practice Address - City:KATHLEEN
Practice Address - State:GA
Practice Address - Zip Code:31047-3327
Practice Address - Country:US
Practice Address - Phone:478-758-0966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health