Provider Demographics
NPI:1275353534
Name:GOLDEN STAY LLC
Entity type:Organization
Organization Name:GOLDEN STAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-858-6318
Mailing Address - Street 1:11610 ESTRELLA CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2234
Mailing Address - Country:US
Mailing Address - Phone:925-858-6318
Mailing Address - Fax:925-947-1042
Practice Address - Street 1:2968 BONNIE LN
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4505
Practice Address - Country:US
Practice Address - Phone:925-858-6318
Practice Address - Fax:925-947-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility