Organization
GOLDEN AGE NURSING HOME DISTRICT
Active
Other names
Golden Age Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VERA J CLINE (ADMINISTRATOR)
(573) 377-4521
Entity
Organization
Contact information
Practice address
404 E 3RD, STOVER, MO 65078
(573) 377-4521
(573) 377-2153
Mailing address
PO BOX 307, STOVER, MO 65078-0307
(573) 377-4521
(573) 377-2153
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031356
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101487205
—
MO
Enumeration date
09/19/2005
Last updated
01/23/2009
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