Provider Demographics
NPI:1174644918
Name:PERSON COUNTY COUNCIL ON AGING INC
Entity Type:Organization
Organization Name:PERSON COUNTY COUNCIL ON AGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IN-HOME CARE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-599-7484
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-0764
Mailing Address - Country:US
Mailing Address - Phone:336-599-7484
Mailing Address - Fax:336-599-3014
Practice Address - Street 1:121A DEPOT ST
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5503
Practice Address - Country:US
Practice Address - Phone:336-599-7484
Practice Address - Fax:336-599-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0453251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health