Provider Demographics
NPI:1548658669
Name:HEARTS OF GOLD CAREGIVERS LLC
Entity type:Organization
Organization Name:HEARTS OF GOLD CAREGIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:KEOLKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-387-0207
Mailing Address - Street 1:700 E PORT MARINA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-2381
Mailing Address - Country:US
Mailing Address - Phone:541-387-0207
Mailing Address - Fax:866-778-3895
Practice Address - Street 1:700 E PORT MARINA DR STE 200
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2381
Practice Address - Country:US
Practice Address - Phone:541-387-0207
Practice Address - Fax:866-778-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2185253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care