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General NPI Number Information
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NPI Number | 1235624305
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Entity Type | Organization
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Legal Business Name | GOLDEN YEARS ASSISTED LIVING CENTER INC.
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 100 N BRYAN ST
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City | BORGER
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State | TX
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Zip | 79007-4010
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Country | US
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Telephone | 806-274-5994
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Fax | 806-274-5992
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Provider Business Mailing Address
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Address Line | 100 N BRYAN ST
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City | BORGER
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State | TX
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Zip | 79007-4010
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Country | US
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Telephone | 806-274-5994
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Fax | 806-274-5992
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Authorized Official
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Title or Position | ASSISTANT MANAGER
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Name | DANYALE GARNER
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Credential |
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Telephone | 806-274-5994
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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 | 148383
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License Number State |
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