NPIMap

Organization Active NPI

Golden Lake Care Home

Doing business as maide llc

  • Assisted Living Facility
  • Las Vegas, NV
National Provider Identifier
1568968733
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
7557-AGC-7 Issued in NV
Legal business name
GOLDEN LAKE CARE HOME
Doing business as
maide llc
Practice address
9719 Tumble Lake CT
Las Vegas, NV 89147-6749
Phone
(702) 755-1800
NPI assigned
Apr 4, 2018
Last updated
Apr 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Authorized official

Name
Sokhena K Huch
Title
Employee/Agent
Phone
(702) 755-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 7557-AGC-7 NV Primary

Addresses

Primary practice location

9719 Tumble Lake CT
Las Vegas, NV 89147-6749

Mailing address

9719 Tumble Lake CT
Las Vegas, NV 89147-6749
Phone (702) 755-1800

Other identifiers 1

IdentifierTypeStateIssuer
9005057599MedicaidNV

Other names 1

  • maide llc Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2285279Maide LLC Dba Golden Lake Care Home9719 Tumble Lake Court, Las Vegas, NV 89147Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bella Care Home7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1568968733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9719 TUMBLE LAKE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476749",
            "telephone_number": "702-755-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9719 TUMBLE LAKE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891476749",
            "telephone_number": "702-755-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN LAKE CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "HUCH",
        "authorized_official_first_name": "SOKHENA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EMPLOYEE/AGENT",
        "authorized_official_telephone_number": "702-755-1800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NV",
            "license": "7557-AGC-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9005057599",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "maide llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.