- Enrollment id
- O20100324000725
- Enrollment state
- FL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1588865927
- Multiple npi flag
- N
- Ccn
- 107697
- Associate id
- 5092736264
- Organization name
- GOLDENCARE HOME HEALTH AGENCY, INC.
- Incorporation date
- 1995-10-30
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 780 NW 42ND AVE
- Address line 2
- STE 300
- City
- MIAMI
- State
- FL
- Zip code
- 331265536