Organization
GOLDEN COMMUNITY CARE ADULT FAMILY HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHOULOME HAROLD GUIDI (OWNER/PROVIDER)
(509) 280-7164
Entity
Organization
Contact information
Practice address
12121 E MISSION AVE STE C, SPOKANE VALLEY, WA 99206-4832
(509) 443-3102
Mailing address
12121 E MISSION AVE STE C, SPOKANE VALLEY, WA 99206-4832
(509) 443-3102
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
752707
—
WA
Enumeration date
02/19/2020
Last updated
02/19/2020
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