Healthcare Provider Details

I. General information

NPI: 1285842609
Provider Name (Legal Business Name): CROCKETT COUNTY OFFICE ON AGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 S BELLS ST
ALAMO TN
38001-2120
US

IV. Provider business mailing address

739 S BELLS ST
ALAMO TN
38001-2120
US

V. Phone/Fax

Practice location:
  • Phone: 731-696-2050
  • Fax: 731-696-4637
Mailing address:
  • Phone: 731-696-2050
  • Fax: 731-696-4637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberH445043
License Number StateTN

VIII. Authorized Official

Name: MRS. DOROTHY LUCILLE LEGGETT
Title or Position: DIRECTOR
Credential:
Phone: 731-696-2050