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General NPI Number Information
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NPI Number | 1457954984
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Entity Type | Organization
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Legal Business Name | GOLDEN OAKS, LLC
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 11701 W 60TH PL
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City | SHAWNEE
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State | KS
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Zip | 66203-2623
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Country | US
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Telephone | 913-717-6257
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Fax |
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Provider Business Mailing Address
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Address Line | 11701 W 60TH PL
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City | SHAWNEE
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State | KS
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Zip | 66203-2623
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Country | US
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Telephone | 913-717-6257
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FELECIA FROE
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Credential | MD
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Telephone | 808-349-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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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 |
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License Number State |
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