# LUTHERAN HOME FOR THE AGED

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LUTHERAN HOME FOR THE AGED
- **Other names:** LUTHERAN HOME - HOME HEALTH, Providence Home Health & Hospice
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619939196
- **Legal business name:** LUTHERAN HOME FOR THE AGED
- **Authorized official:** JACKIE S PAYNE CPA (CFO)
- **Authorized official phone:** (573) 335-0158

## Contact information

- **Practice address:** 2825 BLOOMFIELD RD, CAPE GIRARDEAU, MO 63703-6335
- **Practice address phone:** (573) 334-1515
- **Practice address fax:** (573) 986-6216
- **Mailing address:** 2825 BLOOMFIELD RD, CAPE GIRARDEAU, MO 63703-6335
- **Mailing address phone:** (573) 334-1515
- **Mailing address fax:** (573) 986-6216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 539-9 | MO | Yes |

## Other

- **Enumeration date:** 04/03/2006
- **Last updated:** 03/06/2023