Provider Demographics
NPI:1093184467
Name:POINTE COUPEE COUNCIL ON AGING
Entity Type:Organization
Organization Name:POINTE COUPEE COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-638-4402
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-0110
Mailing Address - Country:US
Mailing Address - Phone:225-638-4402
Mailing Address - Fax:225-638-4403
Practice Address - Street 1:2112 FALSE RIVER DRIVE
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760
Practice Address - Country:US
Practice Address - Phone:225-638-4402
Practice Address - Fax:225-638-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)