Provider Demographics
NPI:1588166805
Name:GOLDEN ELDERLY CARE SUITES LLC
Entity type:Organization
Organization Name:GOLDEN ELDERLY CARE SUITES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:HUELMA
Authorized Official - Last Name:STRANDLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-447-7717
Mailing Address - Street 1:1066 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8429
Mailing Address - Country:US
Mailing Address - Phone:763-447-7717
Mailing Address - Fax:
Practice Address - Street 1:7245 HIDDEN HOLLOW CT
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-3836
Practice Address - Country:US
Practice Address - Phone:736-447-7717
Practice Address - Fax:651-484-5130
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN ELDERLY CARE SUITES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN382983251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health