Provider Demographics
NPI:1275879009
Name:W CENTRAL FL AREA AGENCY ON AGING, INC.
Entity Type:Organization
Organization Name:W CENTRAL FL AREA AGENCY ON AGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-740-3888
Mailing Address - Street 1:5905 BRECKENRIDGE PKWY
Mailing Address - Street 2:STE. F
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-4239
Mailing Address - Country:US
Mailing Address - Phone:813-740-3888
Mailing Address - Fax:813-623-1342
Practice Address - Street 1:5905 BRECKENRIDGE PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4239
Practice Address - Country:US
Practice Address - Phone:813-740-3888
Practice Address - Fax:813-623-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable