Golden Retreat Shelter Care Center, Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL5846 Issued in FL

Legal business name

GOLDEN RETREAT SHELTER CARE CENTER, INC.

Practice address

4410 Moncrief Rd W
Jacksonville, FL 32209-1228

Phone

(904) 764-2581

NPI assigned

Jun 10, 2014

Last updated

Jun 10, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abdullah Shah

Title

Owner

Phone

(904) 764-2581

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1245643915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 MONCRIEF RD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322091228",
            "telephone_number": "904-764-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MONCRIEF RD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322091228",
            "telephone_number": "904-764-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN RETREAT SHELTER CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ABDULLAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-764-2581"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL5846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141158600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Care Transportation Group LLC
• Golden Days Assisted Living
• Golden Grace Home Care LLC
• Golden Lakes Support Services
• Golden Quality Transport, LLC
• Golden Touch Healthcare LLC
• Alisa Golden, RDH
• Christopher Golden, QASP
• Franciela Balen Golden, DO
• Marla Golden, D.O.

• Assisted Living Facility (Mental Illness) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.