Provider Demographics
NPI:1003012089
Name:IR COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:IR COUNTY COUNCIL ON AGING
Other - Org Name:SENIOR RESOURCE ASSN., INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEIGL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-569-0760
Mailing Address - Street 1:694 14TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5770
Mailing Address - Country:US
Mailing Address - Phone:772-569-0760
Mailing Address - Fax:
Practice Address - Street 1:694 14TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5770
Practice Address - Country:US
Practice Address - Phone:772-569-0760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)