Provider Demographics
NPI:1356590285
Name:GOLDEN PALM ASSISTED LIVING FACILITY, INC.
Entity type:Organization
Organization Name:GOLDEN PALM ASSISTED LIVING FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:O
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-300-1477
Mailing Address - Street 1:7280 NW 169TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4120
Mailing Address - Country:US
Mailing Address - Phone:305-826-9261
Mailing Address - Fax:305-779-6968
Practice Address - Street 1:7280 NW 169TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4120
Practice Address - Country:US
Practice Address - Phone:305-826-9261
Practice Address - Fax:305-779-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility