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General NPI Number Information
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NPI Number | 1902091077
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Entity Type | Organization
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Legal Business Name | NACOGDOCHES COUNTY AGING COMMITTEE, INC.
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 621 HARRIS ST
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City | NACOGDOCHES
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State | TX
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Zip | 75964-5205
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Country | US
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Telephone | 936-569-6350
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Fax | 936-560-1797
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Provider Business Mailing Address
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Address Line | 621 HARRIS ST
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City | NACOGDOCHES
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State | TX
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Zip | 75964-5205
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Country | US
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Telephone | 936-569-6350
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Fax | 936-560-1797
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Authorized Official
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Title or Position | DIRECTOR
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Name | TAMMY LYNN BLANK
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Credential |
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Telephone | 936-569-6350
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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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