Provider Demographics
NPI:1780142505
Name:GOLDEN YEARS CASTLE PROPERTY HOLDINGS LLC
Entity type:Organization
Organization Name:GOLDEN YEARS CASTLE PROPERTY HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:OGANA
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-240-9305
Mailing Address - Street 1:2060 ARCANE AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1405
Mailing Address - Country:US
Mailing Address - Phone:775-747-7171
Mailing Address - Fax:775-747-7172
Practice Address - Street 1:2060 ARCANE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-1405
Practice Address - Country:US
Practice Address - Phone:775-747-7171
Practice Address - Fax:775-747-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities