Healthcare Provider Details
I. General information
NPI: 1518890177
Provider Name (Legal Business Name): GOLDEN YEARS ADULT FAMILY HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2710 NUMBER 1 CANYON RD
WENATCHEE WA
98801-2452
US
IV. Provider business mailing address
2710 NUMBER 1 CANYON RD # 24
WENATCHEE WA
98801-2452
US
V. Phone/Fax
- Phone: 509-860-0863
- Fax:
- Phone: 509-860-0863
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 313M00000X |
| Taxonomy | Nursing Facility/Intermediate Care Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FABIOLA
GARIBAY
Title or Position: OWNER
Credential:
Phone: 509-860-0863