Golden Age Nursing Center, LLC
Organization Active NPI Nursing Facility/Intermediate Care Facility · Jena, LA
NPI 1013016567 · NPPES record last updated Sep 23, 2008
Key facts
- NPI
- 1013016567
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 481 (LA)
- Legal business name
- GOLDEN AGE NURSING CENTER, LLC
- Practice address
- 5877 Aimwell Rd.
Jena, LA 71342-3020 - Phone
- (318) 992-4175
- Fax
- (318) 992-4177
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles B. McCartney
- Title
- Owner/Manager
- Phone
- (318) 992-4175
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 481 | LA | Yes |
| Skilled Nursing Facility | 314000000X | 481 | LA | |
| Nursing Facility Supplies (DME) | 332BN1400X | 481 | LA |
Addresses
Primary practice location
5877 Aimwell Rd.
Jena, LA 71342-3020
Mailing address
PO Box 3020
Jena, LA 71342-3020
Phone (318) 992-4175
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1684317 | Medicaid | LA | |
| 1520250 | Medicaid | LA |
Other providers in Jena, LA
- Patrice P Flaherty
- Rachel Gaddis Floyd
- Linda Ford
- Bradley Scott Foster
- Cecil Clyde Gaddis
- Denice Gordy
- Lauren Paige Grant
- Traci Gray
- Elizabeth Elois Greene
- Pamela Ruth Hamilton
All providers in Jena, LA · Nursing Facility/Intermediate Care Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.