MEDICARE: HOCKLEY COUNTY SENIOR CITIZENS ASSOCIATION, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor	000150600	TX
2	332U00000X	Home Delivered Meals		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518997386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOCKLEY COUNTY SENIOR CITIZENS ASSOCIATION, INC

Provider Business Mailing Address
First Line	:	1202 HOUSTON ST
Second Line	:
City	:	LEVELLAND
State	:	TX
Zip	:	79336-3524
Country	:	US
Telephone Number	:	806-894-2228
Fax Number	:	806-894-2220

Provider Business Practice Location Address
First Line	:	1202 HOUSTON ST
Second Line	:
City	:	LEVELLAND
State	:	TX
Zip	:	79336-3524
Country	:	US
Telephone Number	:	806-894-2228
Fax Number	:	806-894-2220

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. SHELLY BAIGEN
Credential	:
Telephone Number	:	806-894-2228

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	09/15/2020

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