Healthcare Provider Details

I. General information

NPI: 1942126768
Provider Name (Legal Business Name): GOLDEN SWAN BY THE LAKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17331 SPRING TREE LN
BOCA RATON FL
33487-1106
US

IV. Provider business mailing address

17331 SPRING TREE LN
BOCA RATON FL
33487-1106
US

V. Phone/Fax

Practice location:
  • Phone: 954-867-8080
  • Fax:
Mailing address:
  • Phone: 954-867-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. KATYA VUSCAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-867-8080