# GOLDEN COMMUNITY CARE ADULT FAMILY HOME, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164055091
- **Authorized official:** MAHOULOME HAROLD GUIDI (OWNER/PROVIDER)
- **Authorized official phone:** (509) 280-7164

## Contact information

- **Practice address:** 12121 E MISSION AVE STE C, SPOKANE VALLEY, WA 99206-4832
- **Practice address phone:** (509) 443-3102
- **Mailing address:** 12121 E MISSION AVE STE C, SPOKANE VALLEY, WA 99206-4832
- **Mailing address phone:** (509) 443-3102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/19/2020
- **Last updated:** 02/19/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 752707 | — | WA |