Golden Age Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

7455 Issued in OK

Legal business name

GOLDEN AGE HEALTH CARE, INC.

Practice address

2801 N Kickapoo Ave
Suite a
Shawnee, OK 74804-1709

Phone

(405) 878-8775

Fax

(405) 878-8776

NPI assigned

Oct 3, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Nathan Sowah

Title

Administrator

Phone

(405) 878-8772

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alleve Home Care Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1679560957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N KICKAPOO AVE",
            "address_2": "SUITE A",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041709",
            "telephone_number": "405-878-8775",
            "fax_number": "405-878-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N KICKAPOO AVE",
            "address_2": "SUITE A",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041709",
            "telephone_number": "405-878-8775",
            "fax_number": "405-878-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "SOWAH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "405-878-8772",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200095690A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alleve Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Good Life Enterprises, Inc.
• Rachel Alexandra Good
• Tara Goodson

• All providers in Shawnee, OK
• Home Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.