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General NPI Number Information
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NPI Number | 1679785976
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Entity Type | Organization
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Legal Business Name | RED RIVER COUNCIL ON AGING, INC.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1825 FRONT STREET
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City | COUSHATTA
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State | LA
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Zip | 71019
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Country | US
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Telephone | 318-932-5721
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Fax | 318-932-9572
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Provider Business Mailing Address
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Address Line | P.O. DRAWER 688
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City | COUSHATTA
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State | LA
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Zip | 71019
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Country | US
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Telephone | 318-932-5721
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Fax | 318-932-9572
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARY S. WAILES
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Credential |
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Telephone | 318-932-5721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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