Golden Ridge Assited Living

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GOLDEN RIDGE ASSITED LIVING

Practice address

200 Montana Ave
Lead, SD 57754-1051

Phone

(605) 639-0115

NPI assigned

Aug 27, 2021

Last updated

Aug 27, 2021By 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

Robert Bagdon

Title

Coo

Phone

(724) 961-6061

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1336816222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MONTANA AVE",
            "city": "LEAD",
            "state": "SD",
            "postal_code": "577541051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MONTANA AVE",
            "city": "LEAD",
            "state": "SD",
            "postal_code": "577541051",
            "telephone_number": "605-639-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN RIDGE ASSITED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "BAGDON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "724-961-6061"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci Carsten, LMT
• Jamie Kay Dahl, LPC
• Steven Warren Fox, D.M.D.
• Golden Ridge Ventures LLC
• Kristy Nicole Greene, CCC, MS
• Todd Kevin Jones, DDS
• Garrett Kohler, LPC
• Kort Herman DMD PC

• Adult Care Home Facility in Lead, SD
• Providers in Lead, SD by specialty
• Adult Care Home Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.