Provider Demographics
NPI:1962056523
Name:GOLDEN VIEW GUEST HOME, INC.
Entity type:Organization
Organization Name:GOLDEN VIEW GUEST HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELOSO
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR CERTIF
Authorized Official - Phone:951-845-7734
Mailing Address - Street 1:P.O. BOX 726
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220
Mailing Address - Country:US
Mailing Address - Phone:951-845-7734
Mailing Address - Fax:951-769-9179
Practice Address - Street 1:5466 WEST WILSON
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220
Practice Address - Country:US
Practice Address - Phone:951-845-7734
Practice Address - Fax:951-769-9179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility