GOLDEN AGE SUPERVISORY HOME (NPI# 1245386085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245386085 |
| Entity Type | Organization |
| Organization Name | GOLDEN AGE SUPERVISORY HOME |
| Practice Address |
118 E 11th Street Eloy AZ 85231 |
| Practice Telephone | 5204667885 |
| Practice Fax Number | 5204667885 |
| Mailing Telephone | 5204667885 |
| Mailing Fax Number | 5204667885 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ROSA DIAZ CAMPOS (OWNER MANAGER) |
| Authorized Official Telephone | 5204667885 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 537847 | 05 |
| Street Address |
118 E 11TH STREET |
| City | ELOY |
| State | AZ |
| Zip Code | 85231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316279516 | Kirk D. Mosley | Dentist | 3260 N. Toltec Road, Eloy, AZ 85231 | 2010-02-12 |
| 1740345404 | Manuel L. Medina | Social Worker | 4020 N Zapotec Ave, Eloy, AZ 85231-1160 | 2006-12-23 |
| 1568505840 | Anne Foshee Decker | Registered Nurse | 900 N Main St, Eloy, AZ 85231-2040 | 2007-02-15 |
| 1114066412 | Santa Cruz Valley Union High School | Local Education Agency (LEA) | 900 N Main St, Eloy, AZ 85231-2040 | 2007-02-05 |
| 1316081987 | Eloy Elementary School District | Local Education Agency (LEA) | 1011 N Sunshine Blvd, Eloy, AZ 85231-2178 | 2007-02-16 |
| 1144358300 | Maria Del Carmen Hernandez | Psychologist | 1011 N Sunshine Blvd, Eloy, AZ 85231-2178 | 2007-03-01 |
| 1861629834 | Laura's Healing Hands | Clinic/Center | 2952 E Haddan Ct, Eloy, AZ 85231-2708 | 2009-06-17 |
| 1972751923 | Katie Leah Hareid | Dentist | 3130 N Toltec Rd, Eloy, AZ 85231-9617 | 2008-09-03 |
| 1063565141 | Kirk Duncan Mosley | Dentist | 3260 N Toltec Rd, Eloy, AZ 85231-9617 | 2007-01-19 |
| 1518169218 | Toltec Elementary School Distict #22 | Local Education Agency (LEA) | 3315 N Toltec Rd, Eloy, AZ 85231-9680 | 2007-06-04 |
| Find all providers in zip 85231 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730508 | Gheorghe Patrutescu | Assisted Living Facility | 16134 N 72nd Ln, Peoria, AZ 85382-4937 | 2020-11-03 |
| 1942800966 | Yibu Liu | Assisted Living Facility | 3569 E Utopia Rd, Phoenix, AZ 85050-3967 | 2020-10-28 |
| 1386243269 | Harmony House Tucson LLC | Assisted Living Facility | 12651 E Speedway Blvd, Tucson, AZ 85748-2060 | 2020-10-21 |
| 1710586664 | Sunland Springs Memory Care, LLC | Assisted Living Facility | 2415 S Signal Butte Rd, Mesa, AZ 85209-2107 | 2020-10-21 |
| 1487253860 | Ronald Jingco Calaguas | Assisted Living Facility | 2432 W Portobello Ave, Mesa, AZ 85202-7871 | 2020-10-18 |
| 1992303374 | Azi House LLC | Assisted Living Facility | 1200 W Chapala Dr, Tucson, AZ 85704-4521 | 2020-10-16 |
| 1609474030 | Fisher Family Home LLC | Assisted Living Facility | 2927 W Redfield Rd, Phoenix, AZ 85053-7712 | 2020-10-16 |
| 1235736687 | Ana's Assisted Living Home, LLC | Assisted Living Facility | 13238 N 35th St, Phoenix, AZ 85032-6110 | 2020-10-07 |
| 1205433844 | Angelic Care LLC | Assisted Living Facility | 15247 W Wethersfield Rd, Surprise, AZ 85379-9177 | 2020-10-07 |
| 1689281347 | Gilbert Al Partners, Lp | Assisted Living Facility | 1445 E Willis Rd, Gilbert, AZ 85297-7352 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.