Provider Demographics
NPI:1528605540
Name:GOLDEN COAST SENIOR LIVING
Entity Type:Organization
Organization Name:GOLDEN COAST SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-533-4025
Mailing Address - Street 1:28562 OSO PKWY # D-319
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5595
Mailing Address - Country:US
Mailing Address - Phone:949-533-4025
Mailing Address - Fax:
Practice Address - Street 1:25321 DE SALLE ST
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5049
Practice Address - Country:US
Practice Address - Phone:949-533-4025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility