Provider Demographics
NPI:1033935481
Name:GOLDEN AGE PARENTAL CARE LLC
Entity type:Organization
Organization Name:GOLDEN AGE PARENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:ONYENJIUWA
Authorized Official - Last Name:MADAGU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-355-8628
Mailing Address - Street 1:1301 JUSTIN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2183
Mailing Address - Country:US
Mailing Address - Phone:214-355-8628
Mailing Address - Fax:
Practice Address - Street 1:247 E SW PARKWAY
Practice Address - Street 2:APT. 605
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067
Practice Address - Country:US
Practice Address - Phone:214-355-8628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty