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General NPI Number Information
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NPI Number | 1003369802
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Entity Type | Organization
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Legal Business Name | GOLDEN CARE FACILITY LLC
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 4909 ROYAL CT S
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-2826
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Country | US
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Telephone | 561-469-1660
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Fax | 561-429-4860
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Provider Business Mailing Address
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Address Line | 4909 ROYAL CT S
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-2826
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Country | US
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Telephone | 561-469-1660
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Fax | 561-429-4860
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | PEDRO L REYES JR.
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Credential |
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Telephone | 561-371-3312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 12875
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License Number State | FL
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