Golden Retreat Senior Living Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOLDEN RETREAT SENIOR LIVING INC

Practice address

5101 NW 47TH Ave
Coconut Creek, FL 33073-4942

Phone

(954) 428-0241

NPI assigned

Oct 18, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Dakarai Tulloch

Title

Administrator

Phone

(786) 356-0401

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539820800000",
    "number": "1356817290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 NW 47TH AVE",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734942",
            "telephone_number": "954-428-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 NW 47TH AVE",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734942",
            "telephone_number": "954-428-0241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 Campground Rd",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302522500",
            "country_code": "US",
            "telephone_number": "770-957-2419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOLDEN RETREAT SENIOR LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A",
        "authorized_official_last_name": "TULLOCH",
        "authorized_official_first_name": "DAKARAI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-356-0401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloden Swan Alf, Inc.
• GNC Therapies
• Shelley I Gogel, L.D.O.
• Gold Coast Medical Supplier
• Golden Retreat at Coconut Creek
• Robert Goldsmith
• Luis Fernando Gomez, D.D.S.
• Alejandro Ramon Gonzalez Ballagas, DPM
• Syren Gonzalez Perez, DMD
• Tatianna Alexis Gonzalez

• Assisted Living Facility in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.