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Contact Information

GOLDEN AGE NURSING HOME DISTRICT
404 E 3RD ST
STOVER, MO65078-0947
 Phone: 573-377-4521
 Fax: 573-377-2153
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for GOLDEN AGE NURSING HOME DISTRICT

NPI Number 1790770444
LBN Legal business name GOLDEN AGE NURSING HOME DISTRICT
Authorized official DONNA BOWERS - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/19/2005
Last updated 05/20/2026 - About 2 weeks ago
Identifiers
MO License # 031356
MO Medicaid 101487205
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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