Provider Demographics
NPI:1386074565
Name:GOLDEN YEARS RETIREMENT CORP.
Entity type:Organization
Organization Name:GOLDEN YEARS RETIREMENT CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ARQUITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-294-9141
Mailing Address - Street 1:441 E CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880
Mailing Address - Country:US
Mailing Address - Phone:863-294-9141
Mailing Address - Fax:863-808-5790
Practice Address - Street 1:441 E CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880
Practice Address - Country:US
Practice Address - Phone:863-294-9141
Practice Address - Fax:863-808-5790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994096251E00000X
FL231001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL333Medicaid