National Provider Identifier Database

GOLDEN AGE SUPERVISORY HOME
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.


Contact Information

GOLDEN AGE SUPERVISORY HOME
118 E 11TH STREET
ELOY, AZ85231
Phone: 520-466-7885
Fax: 520-466-7885
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for GOLDEN AGE SUPERVISORY HOME

NPI Number 1245386085
Legal business name
LBN
GOLDEN AGE SUPERVISORY HOME
Authorized official ROSA CAMPOS - (OWNER MANAGER)
Entity Organization
Organization subpart No
Enumeration date 01/26/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 537847

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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