Provider Demographics
NPI:1720389257
Name:GOLDEN VACATIONS
Entity Type:Organization
Organization Name:GOLDEN VACATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIBBY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:805-304-3702
Mailing Address - Street 1:5066 HIDDEN PARK CT
Mailing Address - Street 2:B-106
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-7611
Mailing Address - Country:US
Mailing Address - Phone:805-304-3702
Mailing Address - Fax:
Practice Address - Street 1:5066 HIDDEN PARK CT
Practice Address - Street 2:B-106
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-7611
Practice Address - Country:US
Practice Address - Phone:805-304-3702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care