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General NPI Number Information
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NPI Number | 1770361198
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Entity Type | Organization
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Legal Business Name | GOLDEN YEARS
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 302 GOLDENROD DR
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City | PASADENA
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State | MD
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Zip | 21122-7114
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Country | US
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Telephone | 815-593-6634
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Fax |
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Provider Business Mailing Address
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Address Line | 13614 LEGACY CIR APT L
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City | HERNDON
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State | VA
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Zip | 20171-4710
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Country | US
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Telephone | 815-593-6634
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RAKESH KUMAR SINGH
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Credential |
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Telephone | 815-593-6634
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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 |
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License Number State |
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