Organization
GOLDEN LAKE CARE HOME
Active
Other names
maide llc
Organization subpart
No
Provider details
NPI number
Authorized official
SOKHENA K HUCH (EMPLOYEE/AGENT)
(702) 755-1800
Entity
Organization
Contact information
Practice address
9719 TUMBLE LAKE CT, LAS VEGAS, NV 89147-6749
(702) 755-1800
Mailing address
9719 TUMBLE LAKE CT, LAS VEGAS, NV 89147-6749
(702) 755-1800
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
7557-AGC-7
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005057599
—
NV
Enumeration date
04/04/2018
Last updated
04/04/2018
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