A Golden Retreat Care Home, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10702H Issued in AZ

Legal business name

A GOLDEN RETREAT CARE HOME, LLC

Doing business as

A Golden Retreat Care Home

Practice address

18330 W Marconi Ave
Surprise, AZ 85388-2358

Phone

(623) 297-4925

Fax

(623) 399-1152

NPI assigned

Apr 18, 2018

Last updated

Apr 18, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David K Stutsman

Title

Member

Phone

(623) 297-4925

Specialties & licenses 1

Addresses

Other names 1

• A Golden Retreat Care Home Doing business as

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1821585423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8974 W RUTH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853457978",
            "telephone_number": "623-297-4925",
            "fax_number": "623-399-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18330 W MARCONI AVE",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853882358",
            "telephone_number": "623-297-4925",
            "fax_number": "623-399-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A GOLDEN RETREAT CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "STUTSMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "623-297-4925",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL10702H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Golden Retreat Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.