Provider Demographics
NPI:1821637745
Name:GOLDEN MEMORIES LLC
Entity Type:Organization
Organization Name:GOLDEN MEMORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-252-4122
Mailing Address - Street 1:1162 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5044
Mailing Address - Country:US
Mailing Address - Phone:786-252-4122
Mailing Address - Fax:305-819-8710
Practice Address - Street 1:1162 W 30TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5044
Practice Address - Country:US
Practice Address - Phone:786-252-4122
Practice Address - Fax:305-819-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility