Organization
GOLDEN RETREAT SHELTER CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDULLAH SHAH (OWNER)
(904) 764-2581
Entity
Organization
Contact information
Practice address
4410 MONCRIEF RD W, JACKSONVILLE, FL 32209-1228
(904) 764-2581
Mailing address
4410 MONCRIEF RD W, JACKSONVILLE, FL 32209-1228
(904) 764-2581
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL5846
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141158600
—
FL
Enumeration date
06/10/2014
Last updated
06/10/2014
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