Provider Demographics
NPI:1811720865
Name:GOLDEN AGE SENIORS OF LAUDERDALE, INC
Entity type:Organization
Organization Name:GOLDEN AGE SENIORS OF LAUDERDALE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-778-3157
Mailing Address - Street 1:PO BOX 16472
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-6472
Mailing Address - Country:US
Mailing Address - Phone:305-778-3157
Mailing Address - Fax:888-538-2226
Practice Address - Street 1:1510 SW 68TH TER
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-4338
Practice Address - Country:US
Practice Address - Phone:305-778-3157
Practice Address - Fax:888-538-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility