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General NPI Number Information
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NPI Number | 1831252212
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Entity Type | Organization
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Legal Business Name | AREA 10 AGENCY ON AGING
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 630 EDGEWOOD DR
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City | ELLETTSVILLE
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State | IN
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Zip | 47429-1134
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Country | US
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Telephone | 812-876-3383
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Fax |
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Provider Business Mailing Address
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Address Line | 630 EDGEWOOD DR
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City | ELLETTSVILLE
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State | IN
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Zip | 47429-1134
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Country | US
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Telephone | 812-876-3383
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JEWEL ECHELBARGER
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Credential |
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Telephone | 812-876-3383
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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 | 763020-IN
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License Number State | IN
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