Provider Demographics
NPI:1801209259
Name:GOLDEN GENERATION SENIOR CARE INC.
Entity Type:Organization
Organization Name:GOLDEN GENERATION SENIOR CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-525-2205
Mailing Address - Street 1:5775 WAYZATA BLVD
Mailing Address - Street 2:STE 700
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1222
Mailing Address - Country:US
Mailing Address - Phone:952-525-2205
Mailing Address - Fax:800-261-0526
Practice Address - Street 1:5775 WAYZATA BLVD
Practice Address - Street 2:STE 700
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1222
Practice Address - Country:US
Practice Address - Phone:952-525-2205
Practice Address - Fax:800-261-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility