Organization
GOLDEN AGE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY E. CARROLL NFA (EXECUTIVE DIRECTOR)
(512) 398-2362
Entity
Organization
Contact information
Practice address
1505 S MAIN ST, LOCKHART, TX 78644-3945
(512) 398-2362
(512) 398-5591
Mailing address
1505 S MAIN ST, LOCKHART, TX 78644-3945
(512) 398-2362
(512) 398-5591
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116823
TX
Other
Enumeration date
12/06/2006
Last updated
08/22/2020
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