Golden Age Adult Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOLDEN AGE ADULT HOME

Practice address

715 E Sycamore St
Fresno, TX 77545-7897

Phone

(281) 431-2477

Fax

(281) 431-0106

NPI assigned

Sep 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Willie Walker Sr.

Title

Owner

Phone

(281) 431-2477

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1295921138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E SYCAMORE ST",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775457897",
            "telephone_number": "281-431-2477",
            "fax_number": "281-431-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E SYCAMORE ST",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775457897",
            "telephone_number": "281-431-2477",
            "fax_number": "281-431-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE ADULT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-431-2477",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.