Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Golden Manor Assisted Living Facility LLC

Organization Assisted Living Facility · NPI 1396358792

Golden Manor Assisted Living Facility LLC is an Assisted Living Facility in Lake City, Florida. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

197 NW Gwen Lake Ave
Lake City, FL 32055-3711
Phone: (386) 697-9425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1396358792
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mardell Jackson — Administrator · (386) 697-9425
NPI enumeratedAugust 25, 2020
Last updated in NPPESAugust 25, 2020
Certification dateAugust 25, 2020
Mailing addressPo Box 2666, Lake City, FL 32056-2666

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