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Organization

GOLDEN AGE HOSPICE, INC

Active
Other names
Alleve Hospice
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LATONYA FAYE ROBINSON LCSW (PRESIDENT/ADMINISTRATOR)
(405) 605-7787
Entity
Organization

Contact information

Practice address
908 S.W. 107TH ST., OKLAHOMA CITY, OK 73170-5244
(405) 605-7787
(405) 605-7789
Mailing address
908 S.W. 107TH ST., OKLAHOMA CITY, OK 73170-5244
(405) 605-7787
(405) 605-7789

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
4186
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000371642001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
07/07/2005
Last updated
11/23/2010
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