Provider Demographics
NPI:1275192403
Name:COUNCIL OF PREVENTIVE & SUPPORTIVE SERVICES FOR THE AGING
Entity Type:Organization
Organization Name:COUNCIL OF PREVENTIVE & SUPPORTIVE SERVICES FOR THE AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-254-7547
Mailing Address - Street 1:PO BOX 793
Mailing Address - Street 2:
Mailing Address - City:ROCKY FORD
Mailing Address - State:CO
Mailing Address - Zip Code:81067-0793
Mailing Address - Country:US
Mailing Address - Phone:719-254-7547
Mailing Address - Fax:719-254-7547
Practice Address - Street 1:503 N 9TH ST
Practice Address - Street 2:
Practice Address - City:ROCKY FORD
Practice Address - State:CO
Practice Address - Zip Code:81067-1219
Practice Address - Country:US
Practice Address - Phone:719-254-7547
Practice Address - Fax:719-254-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals