Organization · Type 2 NPI

Golden Girls Residential Care, LLC

Assisted Living Facility · Lewiston, ID

NPI number 1376007435 Active

Practice location

214 Larkspur Ln
Lewiston, ID 83501-9600

Fax (208) 798-1833

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed
Alzheimer Center (Dementia Center)	311500000X	None listed

Assisted Living Facility: 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.

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NPI record

NPI: 1376007435
Entity type: Organization (Type 2)
Issued: Jan 23, 2019
Last updated: Apr 14, 2025
Status: Active

Other names

<unavail>
Living Spring Residential Care · doing business as
Pathways Transport · doing business as

Authorized official

Mr. Lucas J Fowler
President/executive Director
(208) 416-9914

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376007435

Golden Girls Residential Care, LLC's National Provider Identifier is 1376007435, issued on Jan 23, 2019. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Lewiston, ID. The record was last updated on Apr 14, 2025.