Provider Demographics
NPI:1417458621
Name:GOLDEN RETREAT OF NAPLES INC.
Entity Type:Organization
Organization Name:GOLDEN RETREAT OF NAPLES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:HEGUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-571-7868
Mailing Address - Street 1:3670 58TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-2482
Mailing Address - Country:US
Mailing Address - Phone:239-213-4257
Mailing Address - Fax:239-231-2296
Practice Address - Street 1:3670 58TH AVE NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-2482
Practice Address - Country:US
Practice Address - Phone:239-213-4257
Practice Address - Fax:239-231-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13127310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility