Organization
GOLDEN AGE, INC.
Active
Other names
Golden Age Skilled Nursing & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
STAN L BIRCHEM (OWNER)
(641) 856-2757
Entity
Organization
Contact information
Practice address
1915 S 18TH ST, CENTERVILLE, IA 52544-3102
(641) 856-2761
(641) 856-2762
Mailing address
1915 S 18TH ST, CENTERVILLE, IA 52544-3102
(641) 856-2761
(641) 856-2762
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
040983
IA
385H00000X
Respite Care
040983
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0168922
—
IA
05
—
0809376
—
IA
01
—
65257
BCBS PROVIDER #
IA
Enumeration date
11/01/2006
Last updated
12/04/2009
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