Provider Demographics
NPI:1386848653
Name:CHEBOYGAN COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:CHEBOYGAN COUNTY COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:BUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-627-7234
Mailing Address - Street 1:1531 SAND ROAD
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721
Mailing Address - Country:US
Mailing Address - Phone:231-627-7234
Mailing Address - Fax:231-627-4048
Practice Address - Street 1:1531 SAND RD
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-9167
Practice Address - Country:US
Practice Address - Phone:231-627-7234
Practice Address - Fax:231-627-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable