MEDICARE: GOLDEN YEARS ADULT FAMILY HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility

General Provider Information

NPI Number	:	1518890177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN YEARS ADULT FAMILY HOME LLC

Provider Business Mailing Address
First Line	:	2710 NUMBER 1 CANYON RD # 24
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-2452
Country	:	US
Telephone Number	:	509-860-0863
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 NUMBER 1 CANYON RD
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-2452
Country	:	US
Telephone Number	:	509-860-0863
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FABIOLA GARIBAY
Credential	:
Telephone Number	:	509-860-0863

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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