Provider Demographics
NPI:1760668891
Name:ALDA GOINES
Entity Type:Organization
Organization Name:ALDA GOINES
Other - Org Name:GOLDEN ACRES HOME CARE II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-674-1129
Mailing Address - Street 1:2962 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-8824
Mailing Address - Country:US
Mailing Address - Phone:530-674-1129
Mailing Address - Fax:530-674-1506
Practice Address - Street 1:2962 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-8824
Practice Address - Country:US
Practice Address - Phone:530-674-1129
Practice Address - Fax:530-674-1506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515002059310400000X, 3104A0630X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)