Organization Active NPI

Golden Age Healthcare LLC

  • Home Health Agency
  • Houston, TX
National Provider Identifier
1306382023
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOLDEN AGE HEALTHCARE LLC
Practice address
14007 River Keg Dr
Houston, TX 77083-6507
Phone
(713) 540-8723
NPI assigned
Jan 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol Etoama
Title
Manager
Phone
(713) 540-8723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

14007 River Keg Dr
Houston, TX 77083-6507

Mailing address

14007 River Keg Dr
Houston, TX 77083-6507
Phone (713) 540-8723

Other identifiers 1

IdentifierTypeStateIssuer
0MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1306382023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14007 RIVER KEG DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836507",
            "telephone_number": "713-540-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14007 RIVER KEG DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836507",
            "telephone_number": "713-540-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "ETOAMA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-540-8723"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.