Provider Demographics
NPI:1861910325
Name:GOLDEN TOUCH ASSISTED LIVING FACILITY, LLC
Entity type:Organization
Organization Name:GOLDEN TOUCH ASSISTED LIVING FACILITY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:HANSRAJDAI
Authorized Official - Last Name:MATUSIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-337-4090
Mailing Address - Street 1:1580 PETERSON RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8723
Mailing Address - Country:US
Mailing Address - Phone:386-337-4090
Mailing Address - Fax:386-774-6493
Practice Address - Street 1:1362 N SPARKMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-3711
Practice Address - Country:US
Practice Address - Phone:386-337-4090
Practice Address - Fax:386-774-6493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN TOUCH ASSISTED LIVING FACILITY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL13047310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility