# GOLDEN LAKE CARE HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** maide llc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568968733
- **Authorized official:** SOKHENA K HUCH (EMPLOYEE/AGENT)
- **Authorized official phone:** (702) 755-1800

## Contact information

- **Practice address:** 9719 TUMBLE LAKE CT, LAS VEGAS, NV 89147-6749
- **Practice address phone:** (702) 755-1800
- **Mailing address:** 9719 TUMBLE LAKE CT, LAS VEGAS, NV 89147-6749
- **Mailing address phone:** (702) 755-1800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 7557-AGC-7 | NV | Yes |

## Other

- **Enumeration date:** 04/04/2018
- **Last updated:** 04/04/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9005057599 | — | NV |