Provider Demographics
NPI:1730079435
Name:GOLDEN SUMMERS CARE HOME LLC
Entity type:Organization
Organization Name:GOLDEN SUMMERS CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GOLDA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:CARACUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-484-2859
Mailing Address - Street 1:20652 N 16TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4346
Mailing Address - Country:US
Mailing Address - Phone:480-417-0671
Mailing Address - Fax:623-248-6000
Practice Address - Street 1:20652 N 16TH WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-4346
Practice Address - Country:US
Practice Address - Phone:480-265-8202
Practice Address - Fax:623-248-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility