Provider Demographics
NPI:1083781629
Name:STEUBEN COUNTY COUNCIL ON AGING, INC
Entity Type:Organization
Organization Name:STEUBEN COUNTY COUNCIL ON AGING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-665-9856
Mailing Address - Street 1:317 S WAYNE ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-1958
Mailing Address - Country:US
Mailing Address - Phone:260-665-9856
Mailing Address - Fax:260-665-5247
Practice Address - Street 1:317 S WAYNE ST STE 1B
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-1958
Practice Address - Country:US
Practice Address - Phone:260-665-9856
Practice Address - Fax:260-665-5247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)