Organization Name: | GOLDEN YEARS ADULT DAY CARE |
NPI Number: | 1396110052 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY MITCHELL FERGERSON (PRESIDENT) |
Mailing Address: | 770 Industrial Dr Edmonton |
State: | KY US |
Postal Code: | 421298944 |
Phone Number: | 2704322044 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2015 |
NPI Last Update Date: | 12/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |