Organization
GOLDEN HIGH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM KUSHNIR (MANAGER)
(619) 565-3687
Entity
Organization
Contact information
Practice address
517 E DIVISION ST, FOND DU LAC, WI 54935-3735
(920) 921-6800
Mailing address
23 SHENANDOAH DR, LAKEWOOD, NJ 08701-4979
(619) 565-3687
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G055260
WISCONSIN
WI
Enumeration date
03/03/2017
Last updated
03/03/2017
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