Organization
GOLDEN AGE ADULT DAYCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONISHA STALLINGS (OWNER)
(314) 562-7051
Entity
Organization
Contact information
Practice address
1671 S OLD HIGHWAY 141, FENTON, MO 63026-5702
(314) 562-7051
Mailing address
1671 S OLD HIGHWAY 141, FENTON, MO 63026-5702
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122083
—
MO
Enumeration date
08/09/2021
Last updated
08/09/2021
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