Golden Age Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GOLDEN AGE ASSISTED LIVING, INC.

Practice address

6441 S Richmond Ave
Willowbrook, IL 60527-1842

Phone

(630) 774-3590

Fax

(630) 481-4992

NPI assigned

Sep 21, 2021

Last updated

Sep 21, 2021By 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. Damir Missbrenner

Title

Secretary

Phone

(630) 774-3590

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1942971999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6441 S RICHMOND AVE",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271842",
            "telephone_number": "630-774-3590",
            "fax_number": "630-481-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6441 S RICHMOND AVE",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271842",
            "telephone_number": "630-774-3590",
            "fax_number": "630-481-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "MISSBRENNER",
        "authorized_official_first_name": "DAMIR",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "630-774-3590",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Marie Garvey, D.C.
• Agnieszka Janina Gaszak, MSN, APRN, FNP-C
• Sagun Gautam, MD
• Vincent Adam Gebala, APRN
• Katherine Gieseke, WHNP
• Alma N Gonzalez, MD
• Patrick Alford Gordon, PSYD
• Poomani Govender, FNP-C
• Gower School District 62
• Hannah Graber, MSW

• Assisted Living Facility in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.