1. Home
  2. Directory
  3. Washington
  4. Spokane Valley
  5. Custodial Care Facility
  6. NPI Profile

GOLDEN COMMUNITY CARE ADULT FAMILY HOME, LLC
NPI 1164055091
Custodial Care Facility - Adult Care Home in Spokane Valley, WA

Active since February 19, 2020CLIA Certified · 3 labs
12121 E MISSION AVE STE C, SPOKANE VALLEY, WA 99206(509) 443-3102 Get Directions Write a Review

NPPES record last updated: February 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Golden Community Care Adult Family Home, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOLDEN COMMUNITY CARE ADULT FAMILY HOME, LLC (NPI 1164055091) is a healthcare organization registered as an adult care home in Spokane Valley, Washington and active in the NPI registry since February 2020. The organization holds 3 active CLIA laboratory certificates and lists Mahoulome Harold Guidi, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1164055091
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameGOLDEN COMMUNITY CARE ADULT FAMILY HOME, LLC
Location Address12121 E MISSION AVE STE CSpokane Valley, WA 99206-4832
Mailing Address12121 E Mission Ave Ste CSpokane Valley, WA 99206-4832 · (509) 443-3102
Phone(509) 443-3102
Organization SubpartNo
Authorized OfficialMahoulome Harold GuidiOwner/provider · (509) 280-7164
Enumeration DateFebruary 19, 2020
✔ NPI 1164055091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
12121 E MISSION AVE STE C, Spokane Valley, WA 99206
Open in Google Maps ↗

Other Identifiers 1

Medicaid752707WA

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2341835

Golden Community Care Adult Family Home · Spokane, WA
Active · expires Apr 4, 2028
CLIA Number50D2341835
Laboratory TypeAfh
Certificate Effective DateApril 8, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorHarold Guidi
Laboratory Phone(509) 919-5922
Laboratory LocationGolden Community Care Adult Family Home820 N Bates Rd, Spokane, WA 99206
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 50D2344124

Golden Community Care Adult Family Home · Spokane, WA
Active · expires Apr 4, 2028
CLIA Number50D2344124
Laboratory TypeAfh
Certificate Effective DateMay 18, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorHarold Guidi
Laboratory Phone(509) 919-5922
Laboratory LocationGolden Community Care Adult Family Home10211 E 15th Ave, Spokane, WA 99206
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 50D2344126

Golden Community Care Adult Family Home · Spokane, WA
Active · expires Apr 4, 2028
CLIA Number50D2344126
Laboratory TypeAfh
Certificate Effective DateMay 18, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorHarold Guidi
Laboratory Phone(509) 919-5922
Laboratory LocationGolden Community Care Adult Family Home512 N Bowdish Rd, Spokane, WA 99206
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY NOEL BALENADA RN60028557
Registered Nurse
12121 E MISSION AVE STE C
SPOKANE VALLEY, WA 99206
Spokane County (509) 443-3102
MAHOULOME HAROLD GUIDI
Custodial Care Facility (Adult Care Home)
12121 E MISSION AVE STE C
SPOKANE VALLEY, WA 99206
Spokane County (509) 280-7164

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Golden Community Care Adult Family Home, LLC's NPI number?

The NPI number for Golden Community Care Adult Family Home, LLC is 1164055091. It was assigned to this organization in the NPPES registry on February 19, 2020.

Where is Golden Community Care Adult Family Home, LLC located?

Golden Community Care Adult Family Home, LLC is located at 12121 E Mission Ave Ste C, Spokane Valley, WA 99206. The listed phone number is (509) 443-3102.

What is Golden Community Care Adult Family Home, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Golden Community Care Adult Family Home, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Golden Community Care Adult Family Home, LLC was last updated on February 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.