Golden Residential Facility

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

AS390376802 Issued in MI

Legal business name

GOLDEN RESIDENTIAL FACILITY

Practice address

1912 Cambridge Dr
Kalamazoo, MI 49001-4444

Phone

(269) 254-8004

NPI assigned

May 23, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Saundra Williams-Sulaiman

Title

Administrator

Phone

(269) 267-6599

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1407203185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 CAMBRIDGE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490014444",
            "telephone_number": "269-254-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 CAMBRIDGE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490014444",
            "telephone_number": "269-254-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-SULAIMAN",
        "authorized_official_first_name": "SAUNDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-267-6599",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AS390376802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "AS390376802",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neal Warren Gogan, M.D.
• Kasey Fay Goins, PA-C
• Sree Kanta Saran Sai Pawan Ashish Gokavarapu, MD
• Golden Care LLC
• Golden Place Nurse Finders
• May Goldenberg, MD
• Jeremy Zack Goldman, MA, BCBA, LBA
• Lauren Camille Goldstein, MD
• Gerard Joseph Gole, PA-C
• Martha Golubski, MA, TLLP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.