Healthcare Provider Details

I. General information

NPI: 1821125352
Provider Name (Legal Business Name): CALLAHAN COUNTY AGING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 4TH ST STE 302 COURTHOUSE
BAIRD TX
79504
US

IV. Provider business mailing address

400 4TH ST STE 302 COURTHOUSE
BAIRD TX
79504
US

V. Phone/Fax

Practice location:
  • Phone: 325-854-5858
  • Fax: 325-854-5859
Mailing address:
  • Phone: 325-854-5858
  • Fax: 325-854-5859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH LYNN MOOREHEAD
Title or Position: DIRECTOR
Credential:
Phone: 325-854-5858