Provider Demographics
NPI:1386201432
Name:GOLDEN YEARS CASTLE PROPERTY HOLDINGS LLC
Entity Type:Organization
Organization Name:GOLDEN YEARS CASTLE PROPERTY HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:OGANA
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-240-9305
Mailing Address - Street 1:685 AMHURST AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELOCK
Mailing Address - State:NV
Mailing Address - Zip Code:89419-5530
Mailing Address - Country:US
Mailing Address - Phone:775-273-2246
Mailing Address - Fax:
Practice Address - Street 1:685 AMHURST AVE
Practice Address - Street 2:
Practice Address - City:LOVELOCK
Practice Address - State:NV
Practice Address - Zip Code:89419-5530
Practice Address - Country:US
Practice Address - Phone:775-273-2246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home