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General NPI Number Information
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NPI Number | 1174644918
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Entity Type | Organization
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Legal Business Name | PERSON COUNTY COUNCIL ON AGING INC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121A DEPOT ST
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City | ROXBORO
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State | NC
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Zip | 27573-5503
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Country | US
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Telephone | 336-599-7484
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Fax | 336-599-3014
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Provider Business Mailing Address
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Address Line | PO BOX 764
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City | ROXBORO
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State | NC
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Zip | 27573-0764
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Country | US
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Telephone | 336-599-7484
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Fax | 336-599-3014
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Authorized Official
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Title or Position | IN-HOME CARE COORDINATOR
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Name | MS. CONNIE A MORSE
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Credential |
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Telephone | 336-599-7484
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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 | HC0453
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License Number State | NC
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