Healthcare Provider Details

I. General information

NPI: 1942419361
Provider Name (Legal Business Name): THE COUNCIL ON AGING OF MARTIN COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE SALERNO RD
STUART FL
34997-6405
US

IV. Provider business mailing address

900 SE SALERNO RD
STUART FL
34997-6405
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-7800
  • Fax: 772-678-6066
Mailing address:
  • Phone: 772-223-7800
  • Fax: 772-678-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number331
License Number StateFL

VIII. Authorized Official

Name: KAREN RIPPER
Title or Position: PRESIDENT CEO
Credential:
Phone: 772-223-7800