Provider Demographics
NPI:1407626211
Name:HOME FOR GOLDEN AGE LLC
Entity Type:Organization
Organization Name:HOME FOR GOLDEN AGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GOLDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-749-3181
Mailing Address - Street 1:365 NW 43RD CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4731
Mailing Address - Country:US
Mailing Address - Phone:718-749-3181
Mailing Address - Fax:
Practice Address - Street 1:365 NW 43RD CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-4731
Practice Address - Country:US
Practice Address - Phone:718-749-3181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility