Provider Demographics
NPI:1427509587
Name:HC GOLDEN AGE ALF, CORP.
Entity type:Organization
Organization Name:HC GOLDEN AGE ALF, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-804-6750
Mailing Address - Street 1:15295 PALMETTO LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1747
Mailing Address - Country:US
Mailing Address - Phone:350-804-6750
Mailing Address - Fax:305-397-1150
Practice Address - Street 1:15295 PALMETTO LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1747
Practice Address - Country:US
Practice Address - Phone:350-804-6750
Practice Address - Fax:305-397-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12915310400000X
FL12915310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility