Golden Moments Senior Care Center LTD

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0036848 Issued in IL

Legal business name

GOLDEN MOMENTS SENIOR CARE CENTER LTD

Practice address

1021 N Church St
Jacksonville, IL 62650-1301

Phone

(217) 245-4174

Fax

(217) 243-5901

NPI assigned

Jul 8, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Melvin Siegel

Title

President

Phone

(847) 679-0100

Specialties & licenses 1

Addresses

Tax ID family

Golden Moments Senior Care Center LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Golden Moments Senior Care Center LTD.

  • Skilled Nursing Facility
  • Skokie, IL
  • NPI 1922066000
  NPD tax ID

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1467450866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N CHURCH ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501301",
            "telephone_number": "217-245-4174",
            "fax_number": "217-243-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N CHURCH ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501301",
            "telephone_number": "217-245-4174",
            "fax_number": "217-243-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN MOMENTS SENIOR CARE CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-679-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0036848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen G Gerberding, M.D.
• Eric A Giebelhausen, MD
• Jordan Amanda Gill, LSW
• Gillespie 694140 (Jacksonville Developmental Center)
• Go Greene Orthopedics LLC
• Eli G Goodman, MD
• Robert L. Gordon Jr., M.D.
• Susan Diane Green
• Mark Hindley Greene III, MD
• Jon Gregory, CRNA

• Skilled Nursing Facility in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.