Provider Demographics
NPI:1033579677
Name:EAST FELICIANA COUNCIL ON AGING
Entity Type:Organization
Organization Name:EAST FELICIANA COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-683-9862
Mailing Address - Street 1:PO BOX 986
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70722-0986
Mailing Address - Country:US
Mailing Address - Phone:225-683-9862
Mailing Address - Fax:225-683-9860
Practice Address - Street 1:11102 BANK ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-0986
Practice Address - Country:US
Practice Address - Phone:225-683-9862
Practice Address - Fax:225-683-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)