Organization Active NPI

Golden Age Assisted Living,LLC

  • Adult Care Home Facility
  • Goodyear, AZ
National Provider Identifier
1730744889
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
GOLDEN AGE ASSISTED LIVING,LLC
Doing business as
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
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

17176 W Watkins St
Goodyear, AZ 85338-1718

Mailing address

17176 W Watkins St
Goodyear, AZ 85338-1718
Phone (623) 312-2798

Other names 1

  • Golden Age Assisted Living,llc Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "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": "2026-10-12",
        "certification_date": "2026-10-12",
        "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"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; 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.