Golden Age Assisted Living,LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GOLDEN AGE ASSISTED LIVING,LLC

Practice address

17176 W Watkins St
Goodyear, AZ 85338-1718

Phone

(623) 312-2798

Fax

(623) 399-6561

NPI assigned

May 3, 2019

Organization subpart

No

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

Authorized official

Name

Denisa Kaporalis

Title

Member

Phone

(623) 312-2798

Specialties & licenses 1

Addresses

Other names 1

• Golden Age Assisted Living,llc Doing business as

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1730744889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17176 W WATKINS ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381718",
            "telephone_number": "623-312-2798",
            "fax_number": "623-399-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17176 W WATKINS ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381718",
            "telephone_number": "623-312-2798",
            "fax_number": "623-399-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE ASSISTED LIVING,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "KAPORALIS",
        "authorized_official_first_name": "DENISA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "623-312-2798"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Age Assisted Living,llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cherrell Glenn
• Richard Glisson
• Joseleon Godinez, MSN, APRN, FNP-C
• Mary Goggins, LCSW
• Tejpaal Singh Gohlwar, DMD
• Golden Path Healthcare
• Don Aaron Goldsmith, DDS
• Hannah Golonka, MSCN
• Lisa Gomez, LPC
• Alyssa Gonzales

• Adult Care Home Facility in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.