Provider Demographics
NPI:1497122634
Name:GOLDEN MANOR, LLC
Entity Type:Organization
Organization Name:GOLDEN MANOR, LLC
Other - Org Name:GOLDEN MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEONILA
Authorized Official - Middle Name:OLAZO
Authorized Official - Last Name:BELTEJAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-762-2160
Mailing Address - Street 1:2515 WESTFALL RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-6126
Mailing Address - Country:US
Mailing Address - Phone:775-762-2160
Mailing Address - Fax:
Practice Address - Street 1:416 SYSONBY CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-6263
Practice Address - Country:US
Practice Address - Phone:775-762-2160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home