Provider Demographics
NPI:1356665376
Name:GOLDEN PLACE LLC
Entity Type:Organization
Organization Name:GOLDEN PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:EWUSI
Authorized Official - Last Name:NAJEME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-803-1129
Mailing Address - Street 1:109 ROBERT M GREEN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8098
Mailing Address - Country:US
Mailing Address - Phone:502-803-1129
Mailing Address - Fax:
Practice Address - Street 1:109 ROBERT M GREEN DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-8098
Practice Address - Country:US
Practice Address - Phone:502-803-1129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities