Provider Demographics
NPI:1851846943
Name:GOLDEN SPRINGS SENIOR LIVING
Entity type:Organization
Organization Name:GOLDEN SPRINGS SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPORALIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-339-3617
Mailing Address - Street 1:13535 W REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8401
Mailing Address - Country:US
Mailing Address - Phone:602-339-3617
Mailing Address - Fax:
Practice Address - Street 1:13535 W REDFIELD RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8401
Practice Address - Country:US
Practice Address - Phone:602-339-3617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ978650Medicaid