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General NPI Number Information
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NPI Number | 1831647155
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Entity Type | Organization
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Legal Business Name | BRAZOS VALLEY COMMUNITY ACTION PROGRAMS
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 203 W 30TH ST
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City | BRYAN
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State | TX
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Zip | 77803-6923
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Country | US
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Telephone | 979-823-2203
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Fax | 979-775-4277
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Provider Business Mailing Address
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Address Line | PO BOX 4128
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City | BRYAN
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State | TX
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Zip | 77805-4128
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Country | US
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Telephone | 979-595-2801
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Fax | 979-595-2810
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TOM WILKINSON
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Credential |
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Telephone | 979-595-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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