Basic Information
| Provider Information | |||||||||
| NPI: | 1548467947 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GOLDEN DAYS ASSISTED LIVING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3225 N MYRTLE AVE | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322094231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9048794230 | ||||||||
| FaxNumber: | 9048795707 | ||||||||
| Practice Location | |||||||||
| Address1: | 3225 N MYRTLE AVE | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322094231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9048794230 | ||||||||
| FaxNumber: | 9048795707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ROBINSON | ||||||||
| AuthorizedOfficialFirstName: | SHIRLEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9048794230 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | AL9247 | FL | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.