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General NPI Number Information
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NPI Number | 1114928215
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Entity Type | Organization
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Legal Business Name | GAINESVILLE COUNCIL ON AGING INC
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 1311 SW 16TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32608-1128
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Country | US
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Telephone | 352-376-8821
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Fax | 352-376-3654
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Provider Business Mailing Address
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Address Line | 1311 SW 16TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32608-1128
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Country | US
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Telephone | 352-376-8821
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Fax | 352-376-3654
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. EDWARD W HURT
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Credential | CPA
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Telephone | 352-376-8821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1568096
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License Number State | FL
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