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General NPI Number Information
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NPI Number | 1942444070
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY AGING CONSORTIUM
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 5303 S CEDAR ST SUITE 1
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City | LANSING
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State | MI
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Zip | 48911-3800
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Country | US
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Telephone | 517-887-1440
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Fax | 517-887-8071
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Provider Business Mailing Address
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Address Line | 5303 S CEDAR ST SUITE 1
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City | LANSING
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State | MI
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Zip | 48911-3800
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Country | US
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Telephone | 517-887-1440
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Fax | 517-887-8071
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARION T OWEN
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Credential |
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Telephone | 517-887-1385
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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 | MI
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