- Enrollment id
- O20030925000030
- Enrollment state
- PA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1053304345
- Multiple npi flag
- N
- Ccn
- 397286
- Associate id
- 8022929082
- Organization name
- GOLDEN CARE OF NORTHEAST PA, INC.
- Incorporation date
- 1985-01-07
- Incorporation state
- PA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1170 HIGHWAY 315 BLVD
- Address line 2
- STE 4
- City
- PLAINS
- State
- PA
- Zip code
- 187026906
- Practice location type
- HHA BRANCH