Provider Demographics
NPI:1336312008
Name:GOLDEN ABBEY ENTERPRISES, II, INC
Entity Type:Organization
Organization Name:GOLDEN ABBEY ENTERPRISES, II, INC
Other - Org Name:GOLDEN ABBEY ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SALDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-763-9800
Mailing Address - Street 1:1321 HERBERT ST
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-4135
Mailing Address - Country:US
Mailing Address - Phone:386-763-9800
Mailing Address - Fax:386-763-0828
Practice Address - Street 1:1321 HERBERT ST
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-4135
Practice Address - Country:US
Practice Address - Phone:386-763-9800
Practice Address - Fax:386-763-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9902385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care