Organization Active NPI

Golden Pond Adult Day Program, Inc.

  • Adult Day Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1790908226
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
14035 Issued in MD
Legal business name
GOLDEN POND ADULT DAY PROGRAM, INC.
Practice address
4825 Frankford Ave
Baltimore, MD 21206-5226
Phone
(410) 325-2686
Fax
(410) 325-2687
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Gwendolyn Jacobs, R.N.
Title
Executive Director
Phone
(410) 325-2686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 14035 MD Primary

Addresses

Primary practice location

4825 Frankford Ave
Baltimore, MD 21206-5226

Mailing address

PO Box 20355
Towson, MD 21284-0355
Phone (410) 325-2686

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2002147Golden Pond Adult Day Program, Inc4825 Frankford Avenue, Baltimore, MD 21206Certificate of waiverJan 7, 2028

National Provider Directory

National Provider Directory

Locations

4825 Frankford Ave
Baltimore, MD 21206
Phone (410) 325-2686

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790908226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20355",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212840355",
            "telephone_number": "410-325-2686",
            "fax_number": "410-325-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 FRANKFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065226",
            "telephone_number": "410-325-2686",
            "fax_number": "410-325-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN POND ADULT DAY PROGRAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-325-2686",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MD",
            "license": "14035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.