Healthcare Provider Details

I. General information

NPI: 1700075991
Provider Name (Legal Business Name): GOLDEN COMMUNITY ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 NC HIGHWAY 226
BOSTIC NC
28018-7661
US

IV. Provider business mailing address

PO BOX 1217
MARION NC
28752-1217
US

V. Phone/Fax

Practice location:
  • Phone: 828-245-2998
  • Fax: 828-245-2424
Mailing address:
  • Phone: 828-245-2998
  • Fax: 828-245-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID CABLE
Title or Position: ADMINISTRATOR
Credential:
Phone: 828-245-2998