=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518107572
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOOD COUNTY COMMITTEE ON AGING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2009
-----------------------------------------------------
Last Update Date | 05/21/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 E MOORE ST
-----------------------------------------------------
City | GRANBURY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76048-1605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-573-5533
-----------------------------------------------------
Fax | 817-573-2420
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 849
-----------------------------------------------------
City | GRANBURY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76048-0849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-573-5533
-----------------------------------------------------
Fax | 817-573-2420
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EX. DIRECTOR
-----------------------------------------------------
Name | MS. JEANETTE SCOTT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-573-5533
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------