Provider Demographics
NPI:1003369802
Name:GOLDEN CARE FACILITY LLC
Entity Type:Organization
Organization Name:GOLDEN CARE FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:L
Authorized Official - Last Name:REYES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:561-371-3312
Mailing Address - Street 1:4909 ROYAL CT S
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-2826
Mailing Address - Country:US
Mailing Address - Phone:561-469-1660
Mailing Address - Fax:561-429-4860
Practice Address - Street 1:4909 ROYAL CT S
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-2826
Practice Address - Country:US
Practice Address - Phone:561-469-1660
Practice Address - Fax:561-429-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12875310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility