Provider Demographics
NPI:1033160494
Name:GGNSC DOYLESTOWN LP
Entity Type:Organization
Organization Name:GGNSC DOYLESTOWN LP
Other - Org Name:GOLDEN LIVINGCENTER - DOYLESTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC. OF THE GP
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:432 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4414
Mailing Address - Country:US
Mailing Address - Phone:215-345-1452
Mailing Address - Fax:215-345-6816
Practice Address - Street 1:432 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4414
Practice Address - Country:US
Practice Address - Phone:215-345-1452
Practice Address - Fax:215-345-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040502314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101555228Medicaid
PA0005513000OtherINDEPENDENCE BLUE CROSS
PA1015552280001Medicaid
CA395277Medicare Oscar/Certification
PA1015552280001Medicaid