Healthcare Provider Details

I. General information

NPI: 1437526787
Provider Name (Legal Business Name): GOLDEN HC OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2015
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 E DOBKINS ST
DUBLIN TX
76446-2419
US

IV. Provider business mailing address

111 CLIFTON AVE
LAKEWOOD NJ
08701-3342
US

V. Phone/Fax

Practice location:
  • Phone: 254-445-3379
  • Fax: 254-445-4279
Mailing address:
  • Phone: 214-396-3462
  • Fax: 214-396-3482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: KARIN FALKINBURG
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 214-396-3462