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General NPI Number Information
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NPI Number | 1629274659
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Entity Type | Organization
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Legal Business Name | WASHINGTON COUNTY COUNCIL ON AGING, INC.
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 1348 SOUTH BLVD
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City | CHIPLEY
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State | FL
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Zip | 32428-1846
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Country | US
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Telephone | 850-638-6217
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Fax | 850-638-6363
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Provider Business Mailing Address
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Address Line | 1348 SOUTH BLVD
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City | CHIPLEY
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State | FL
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Zip | 32428-1846
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Country | US
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Telephone | 850-638-6217
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Fax | 850-638-6363
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TRACEY LONG
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Credential |
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Telephone | 850-638-6217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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