Golden Arms Assisted Living LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

310A0625X Issued in MS

Legal business name

GOLDEN ARMS ASSISTED LIVING LLC

Practice address

1223 Steven Wood Rd
Fayette, MS 39069-4658

Phone

(601) 786-0600

NPI assigned

Jun 24, 2016

Last updated

Jul 4, 2016By 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

Mrs. Carolyn Hill-Ford Anderson

Title

Owner

Phone

(601) 493-3525

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467590400000",
    "number": "1831540533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 KAISER LAKE RD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391208936",
            "telephone_number": "601-493-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 STEVEN WOOD RD",
            "city": "FAYETTE",
            "state": "MS",
            "postal_code": "390694658",
            "telephone_number": "601-786-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ARMS ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-07-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "HILL-FORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-493-3525",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MS",
            "license": "310A0625X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Fayette, MS
• Providers in Fayette, MS by specialty
• Assisted Living Facility (Mental Illness) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2016; 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.