Provider Demographics
NPI:1154865756
Name:GOLDEN SWAN OF BOCA
Entity Type:Organization
Organization Name:GOLDEN SWAN OF BOCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VUSCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-867-8080
Mailing Address - Street 1:19494 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19494 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2844
Practice Address - Country:US
Practice Address - Phone:954-867-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12872310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility