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General NPI Number Information
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NPI Number | 1598212797
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Entity Type | Organization
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Legal Business Name | OTSEGO COUNTY COMMISSION ON AGING
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1165 ELKVIEW AVE.
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City | GAYLORD
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State | MI
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Zip | 49735
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Country | US
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Telephone | 989-732-1122
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Fax | 989-732-9050
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Provider Business Mailing Address
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Address Line | PO BOX 430
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City | GAYLORD
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State | MI
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Zip | 49734-0430
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Country | US
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Telephone | 989-748-4072
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Fax | 989-732-9050
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DONA J. WISHART
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Credential |
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Telephone | 989-732-1122
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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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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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