Provider Demographics
NPI:1578160321
Name:GOLDEN HORIZONS, LLC
Entity Type:Organization
Organization Name:GOLDEN HORIZONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BLOMQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-203-7731
Mailing Address - Street 1:535 N 600 W
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84701-1767
Mailing Address - Country:US
Mailing Address - Phone:435-896-1990
Mailing Address - Fax:
Practice Address - Street 1:535 N 600 W
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-1767
Practice Address - Country:US
Practice Address - Phone:435-896-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility