Provider Demographics
NPI:1821008533
Name:GOLDEN PALMS RETIREMENT & HEALTH CENTER
Entity Type:Organization
Organization Name:GOLDEN PALMS RETIREMENT & HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-389-4653
Mailing Address - Street 1:2101 TREASURE HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8738
Mailing Address - Country:US
Mailing Address - Phone:956-389-4653
Mailing Address - Fax:956-389-4008
Practice Address - Street 1:2101 TREASURE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8738
Practice Address - Country:US
Practice Address - Phone:956-389-4653
Practice Address - Fax:956-389-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115284314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016350Medicaid
TX001016350Medicaid