Organization Active NPI

Golden Years Outreach Services LLC

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1619409778
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GOLDEN YEARS OUTREACH SERVICES LLC
Practice address
2504 Raeford Rd Ste 113
Fayetteville, NC 28305-5135
Phone
(910) 823-7875
Fax
(910) 491-3393
NPI assigned
Mar 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Monique M Alexander
Title
Agency Director
Phone
(910) 491-3245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2504 Raeford Rd Ste 113
Fayetteville, NC 28305-5135

Mailing address

6760 Willowbrook Dr
Suite 8
Fayetteville, NC 28314-0395

National Provider Directory

National Provider Directory

Locations

2504 Raeford Rd
Ste 113
Fayetteville, NC 28305
Phone (910) 823-7875

2504 Raeford Rd
Ste 8
Fayetteville, NC 28305

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1619409778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 WILLOWBROOK DR",
            "address_2": "SUITE 8",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 RAEFORD RD STE 113",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055135",
            "telephone_number": "910-823-7875",
            "fax_number": "910-491-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN YEARS OUTREACH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "910-491-3245"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.