GOLDEN AGE ADULT DAYCARE NPI 1407521891

NPI Information

NPI: 1407521891
Provider Name: GOLDEN AGE ADULT DAYCARE
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

Address:
1671 S OLD HIGHWAY 141
FENTON, MO
ZIP 63026
Phone: (314) 562-7051
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GOLDEN AGE ADULT DAYCARE is an adult day care clinic center in Fenton, MO. GOLDEN AGE ADULT DAYCARE NPI is 1407521891. The provider is registered as an organization entity type.

The provider's business location address is:

1671 S OLD HIGHWAY 141
FENTON, MO
ZIP 63026-702
Phone: (314) 562-7051

The provider's authorized official is Tonisha Stallings .
The authorized official title is Owner and has the following contact phone number (314) 562-7051.

The enumeration date for this NPI number is 8/9/2021 and was last updated on 8/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	122083	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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