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General NPI Number Information
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NPI Number | 1427509587
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Entity Type | Organization
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Legal Business Name | HC GOLDEN AGE ALF CORP.
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 15295 PALMETTO LAKE DRIVE
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City | MIAMI
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State | FL
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Zip | 33157-1747
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Country | US
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Telephone | 305-964-5270
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Fax | 305-964-5270
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Provider Business Mailing Address
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Address Line | 15295 PALMETTO LAKE DRIVE
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City | MIAMI
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State | FL
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Zip | 33157-1747
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Country | US
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Telephone | 305-964-5270
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Fax | 305-964-5270
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHERINE BOUZA
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Credential |
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Telephone | 305-964-5270
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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 | AL12915
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 12915
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License Number State | FL
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