Provider Demographics
NPI:1659568442
Name:GOLDEN DAYS VILLA INC
Entity Type:Organization
Organization Name:GOLDEN DAYS VILLA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-564-2702
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:439 EAST MAIN
Mailing Address - City:YORKTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78164-0365
Mailing Address - Country:US
Mailing Address - Phone:361-564-9522
Mailing Address - Fax:361-564-9520
Practice Address - Street 1:439 EAST MAIN
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:TX
Practice Address - Zip Code:78164-0365
Practice Address - Country:US
Practice Address - Phone:361-564-9522
Practice Address - Fax:361-564-9520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12001310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility