Healthcare Provider Details

I. General information

NPI: 1386074565
Provider Name (Legal Business Name): GOLDEN YEARS RETIREMENT CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 03/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 E CENTRAL AVENUE
WINTER HAVEN FL
33880
US

IV. Provider business mailing address

441 E CENTRAL AVENUE
WINTER HAVEN FL
33880
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-9141
  • Fax: 863-808-5790
Mailing address:
  • Phone: 863-294-9141
  • Fax: 863-808-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number231001
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299994096
License Number StateFL

VIII. Authorized Official

Name: MARK ALLEN ARQUITT
Title or Position: OWNER
Credential:
Phone: 863-294-9141