Golden Girls Residential Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOLDEN GIRLS RESIDENTIAL CARE, LLC

Practice address

214 Larkspur LN
Lewiston, ID 83501-9600

Phone

(208) 413-9914

Fax

(208) 798-1833

NPI assigned

Jan 23, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Lucas J Fowler

Title

President/Executive Director

Phone

(208) 416-9914

Specialties & licenses 2

Addresses

Other names 2

• Living Spring Residential Care Doing business as
• Pathways Transport Doing business as

Locations

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1376007435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 LARKSPUR LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835019600",
            "telephone_number": "208-413-9914",
            "fax_number": "208-798-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 LARKSPUR LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835019600",
            "telephone_number": "208-413-9914",
            "fax_number": "208-798-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN GIRLS RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-416-9914",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Spring Residential Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pathways Transport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susette Marie Elizabeth Gleason
• Sarah J Glenn, LCSW
• Sandra D. Godfrey, MA, LCPC, LMFT
• Spencer Godfrey
• Marsha D Goeckner, PHARMD
• Gregory Maxwell Gosey, M.D.
• Darci M. Graves, LMSW
• Dennis O. Gray, CADC
• James William Gray III, LMSW
• Donald J Greggain, M.D.

• Assisted Living Facility in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Assisted Living Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.