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General NPI Number Information
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NPI Number | 1417458621
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Entity Type | Organization
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Legal Business Name | GOLDEN RETREAT OF NAPLES INC.
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 3670 58TH AVE NE
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City | NAPLES
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State | FL
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Zip | 34120-2482
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Country | US
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Telephone | 239-213-4257
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Fax | 239-231-2296
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Provider Business Mailing Address
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Address Line | 3670 58TH AVE NE
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City | NAPLES
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State | FL
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Zip | 34120-2482
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Country | US
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Telephone | 239-213-4257
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Fax | 239-231-2296
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | ALICIA V HEGUI
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Credential |
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Telephone | 239-571-7868
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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 | 13127
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License Number State | FL
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