GOLDEN MANOR ASSISTED LIVING FACILITY LLC
NPI 1396358792
Assisted Living Facility in Lake City, FL

Q: What is Golden Manor Assisted Living Facility LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since August 25, 2020

197 NW GWEN LAKE AVE, LAKE CITY, FL 32055(386) 697-9425 Get Directions Write a Review

NPPES record last updated: August 25, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Golden Manor Assisted Living Facility Llc NPPES

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

GOLDEN MANOR ASSISTED LIVING FACILITY LLC (NPI 1396358792) is a healthcare organization registered as an assisted living facility in Lake City, Florida and active in the NPI registry since August 2020. The organization lists Mardell Jackson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1396358792

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameGOLDEN MANOR ASSISTED LIVING FACILITY LLC

Location Address197 NW GWEN LAKE AVELake City, FL 32055-3711

Mailing AddressPo Box 2666Lake City, FL 32056-2666 · (386) 697-9425

Phone(386) 697-9425

Organization SubpartNo

Authorized OfficialMardell JacksonAdministrator · (386) 697-9425

Enumeration DateAugust 25, 2020

NPPES CertifiedAugust 25, 2020

✔ NPI 1396358792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

197 NW GWEN LAKE AVE, Lake City, FL 32055

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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.

MVP MEDICAL TRANSIT LLC

Non-emergency Medical Transport (VAN)

197 NW GWEN LAKE AVE
LAKE CITY, FL 32055

Columbia County (386) 466-9464

MARDELL JACKSON

Assisted Living Facility

197 NW GWEN LAKE AVE
LAKE CITY, FL 32055

Columbia County (386) 697-9425

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 Manor Assisted Living Facility LLC's NPI number?

The NPI number for Golden Manor Assisted Living Facility LLC is 1396358792. It was assigned to this organization in the NPPES registry on August 25, 2020.

Where is Golden Manor Assisted Living Facility LLC located?

Golden Manor Assisted Living Facility LLC is located at 197 NW Gwen Lake Ave, Lake City, FL 32055. The listed phone number is (386) 697-9425.

What is Golden Manor Assisted Living Facility LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Golden Manor Assisted Living Facility LLC was last updated on August 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.