Organization
GOLDEN RESIDENTIAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAUNDRA WILLIAMS-SULAIMAN (ADMINISTRATOR)
(269) 267-6599
Entity
Organization
Contact information
Practice address
1912 CAMBRIDGE DR, KALAMAZOO, MI 49001-4444
(269) 254-8004
Mailing address
1912 CAMBRIDGE DR, KALAMAZOO, MI 49001-4444
(269) 254-8004
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AS390376802
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS390376802
LICENSE NUMBER
MI
Enumeration date
05/23/2016
Last updated
05/23/2016
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