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General NPI Number Information
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NPI Number | 1376687947
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Entity Type | Organization
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Legal Business Name | PADUCAH SENIOR CITIZENS CENTER INC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 805 RICHARDS STREET
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City | PADUCAH
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State | TX
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Zip | 79248
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Country | US
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Telephone | 806-492-3246
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Fax | 806-492-3246
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Provider Business Mailing Address
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Address Line | PO BOX 782 805 RICHARDS STREET
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City | PADUCAH
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State | TX
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Zip | 79248
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Country | US
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Telephone | 806-492-3246
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Fax | 806-492-3246
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Authorized Official
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Title or Position | CHAIRMAN BOARD OF DIRECTORS
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Name | MRS. BOBBY LEA HOLLEY
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Credential |
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Telephone | 806-492-3305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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