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General NPI Number Information
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NPI Number | 1902206915
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Entity Type | Organization
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Legal Business Name | HOUSTON COUNTY AGING SERVICE
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 08/27/2014
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Provider Practice Location Address
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Address Line | 112 E HOUSTON AVE
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City | CROCKETT
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State | TX
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Zip | 75835-1949
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Country | US
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Telephone | 936-544-3255
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Fax | 936-544-9291
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Provider Business Mailing Address
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Address Line | 112 E HOUSTON AVE
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City | CROCKETT
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State | TX
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Zip | 75835-1949
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Country | US
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Telephone | 936-544-3255
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Fax | 936-544-9291
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Authorized Official
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Title or Position | DIRECTOR
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Name | ASHLEY ASHLEY
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Credential |
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Telephone | 936-544-3255
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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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