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NPI Code Detail

MEDICARE: GOLDENLIFE SENIOR CARE

MEDICARE: GOLDENLIFE SENIOR CARE
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
1313M00000XNursing Facility/Intermediate Care Facility100950TX

General Provider Information

NPI Number : 1538170469
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLDENLIFE SENIOR CARE
Provider Business Mailing Address
First Line : 1219 HOLLAND LAKE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-5851
Country : US
Telephone Number : 817-599-0000
Fax Number : 817-596-0751
Provider Business Practice Location Address
First Line : 1219 HOLLAND LAKE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-5851
Country : US
Telephone Number : 817-599-0000
Fax Number : 817-596-0751
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. JANA PAIGE SANDERS
Credential :
Telephone Number : 817-599-0000
Provider Enumeration Date : 08/09/2006
Last Update Date : 08/22/2020

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Directions to “GOLDENLIFE SENIOR CARE ” Practice Location

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