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General NPI Number Information
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NPI Number | 1609072016
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Entity Type | Organization
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Legal Business Name | COUNCIL ON AGING & HUMAN SERVICES
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 210 S MAIN ST
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City | COLFAX
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State | WA
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Zip | 99111-1820
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Country | US
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Telephone | 509-394-4611
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Fax | 509-397-2917
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Provider Business Mailing Address
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Address Line | 210 S MAIN ST PO BOX 107
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City | COLFAX
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State | WA
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Zip | 99111-1820
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Country | US
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Telephone | 509-394-4611
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Fax | 509-397-2917
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Authorized Official
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Title or Position | NUTRITION PROGRAM DIRECTOR
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Name | MR. SCOTT HALLETT
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Credential |
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Telephone | 509-397-4611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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