Provider Demographics
NPI:1023554391
Name:DISTRICT III AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:DISTRICT III AREA AGENCY ON AGING
Other - Org Name:CARE CONNECTION FOR AGING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-747-3107
Mailing Address - Street 1:106 W YOUNG AVE
Mailing Address - Street 2:P.O. BOX 1078
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-1124
Mailing Address - Country:US
Mailing Address - Phone:660-747-3107
Mailing Address - Fax:660-747-3100
Practice Address - Street 1:106 W YOUNG AVE
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1124
Practice Address - Country:US
Practice Address - Phone:660-747-3107
Practice Address - Fax:660-747-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1417075862Medicaid