Healthcare Provider Details

I. General information

NPI: 1932228467
Provider Name (Legal Business Name): KNOX COUNTY AGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 N AVE E
KNOX CITY TX
79529
US

IV. Provider business mailing address

PO BOX 306
KNOX CITY TX
79529
US

V. Phone/Fax

Practice location:
  • Phone: 940-657-3618
  • Fax:
Mailing address:
  • Phone: 940-657-3618
  • Fax: 940-657-3618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number332U0000X
License Number StateTX

VIII. Authorized Official

Name: TRAVIS C FLOYD
Title or Position: COUNTY JUDGE
Credential:
Phone: 940-459-2191