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General NPI Number Information
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NPI Number | 1154381283
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Entity Type | Organization
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Legal Business Name | UNION COUNTY COUNCIL ON AGING AND AGED,INC.
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 615 W HIGH ST
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City | LIBERTY
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State | IN
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Zip | 47353-9573
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Country | US
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Telephone | 765-458-5500
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Fax | 765-458-7722
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Provider Business Mailing Address
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Address Line | PO BOX 333 615 W. HIGH STREET
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City | LIBERTY
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State | IN
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Zip | 47353
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Country | US
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Telephone | 765-458-5500
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Fax | 765-458-7722
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BONNIE L, BLADES
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Credential | RN
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Telephone | 765-458-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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