Healthcare Provider Details

I. General information

NPI: 1518897131
Provider Name (Legal Business Name): GOLDEN HORIZON AFC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 WOODWARD AVE SW
WYOMING MI
49509-3038
US

IV. Provider business mailing address

3260 WOODWARD AVE SW
WYOMING MI
49509-3038
US

V. Phone/Fax

Practice location:
  • Phone: 480-285-4623
  • Fax:
Mailing address:
  • Phone: 480-285-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: NOBEL NKURUNZIZA
Title or Position: ADMINISTRATOR
Credential:
Phone: 480-285-4623