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General NPI Number Information
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NPI Number | 1760519649
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Entity Type | Organization
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Legal Business Name | OLDER AMERICANS COUNCIL OF MID GA
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1283 ADAMS ST
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City | MACON
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State | GA
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Zip | 31201-1568
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Country | US
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Telephone | 478-751-2761
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Fax | 478-751-2765
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Provider Business Mailing Address
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Address Line | 1283 ADAMS ST
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City | MACON
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State | GA
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Zip | 31201-1568
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Country | US
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Telephone | 478-751-2761
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Fax | 478-751-2765
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS LINDA HAMPTON
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Credential |
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Telephone | 478-751-2760
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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 | GA
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