Golden Years Residential Care Facility, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GOLDEN YEARS RESIDENTIAL CARE FACILITY, LLC

Practice address

8920 Loggers Mill Ave
Las Vegas, NV 89143-5423

Phone

(702) 202-6475

NPI assigned

Nov 19, 2019

Organization subpart

No

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

Authorized official

Name

Kristofer Dauz

Title

Administrator

Phone

(702) 480-9021

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Golden Years Memory Care LLC Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1922644459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 LOGGERS MILL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891435423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 LOGGERS MILL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891435423",
            "telephone_number": "702-202-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN YEARS RESIDENTIAL CARE FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "DAUZ",
        "authorized_official_first_name": "KRISTOFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-480-9021"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100539474",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Years Memory Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Golden Victory Medical
• Golden Victory Medical Internal Medicine
• Golden Vista Home Health Services, Inc.
• Golden Years Personal Care LLC
• Golden Years Personal Care LLC
• Golden Years Residential Care, LLC
• Angelique Cassandra Golden, MS, CCC-SLP
• Breonna Golden
• Carolyn L Golden
• Daniel Lewis Golden, MD

• Adult Care Home Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Adult Care Home Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.