Provider Demographics
NPI:1710271762
Name:GOLDEN COVE ASSISTED LIVING FACILITY, INC
Entity Type:Organization
Organization Name:GOLDEN COVE ASSISTED LIVING FACILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR, LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRECIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-281-1886
Mailing Address - Street 1:918 EGAN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-6018
Mailing Address - Country:US
Mailing Address - Phone:407-281-1886
Mailing Address - Fax:407-281-7176
Practice Address - Street 1:918 EGAN DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-6018
Practice Address - Country:US
Practice Address - Phone:407-281-1886
Practice Address - Fax:407-281-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9837310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility