Provider Demographics
NPI:1205278223
Name:GOLDEN YEARS ASSISTED LIVING COMMUNITY
Entity type:Organization
Organization Name:GOLDEN YEARS ASSISTED LIVING COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:401-596-1333
Mailing Address - Street 1:118 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-1823
Mailing Address - Country:US
Mailing Address - Phone:401-596-1333
Mailing Address - Fax:401-596-5559
Practice Address - Street 1:118 HIGH ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-1823
Practice Address - Country:US
Practice Address - Phone:401-596-1333
Practice Address - Fax:401-596-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIALR01479310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility