Provider Demographics
NPI:1407016140
Name:KINGS/TULARE AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:KINGS/TULARE AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:KTAAA DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-324-8006
Mailing Address - Street 1:5957 S MOONEY BLVD
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9394
Mailing Address - Country:US
Mailing Address - Phone:559-624-8000
Mailing Address - Fax:559-624-1042
Practice Address - Street 1:3500 W MINERAL KING AVE
Practice Address - Street 2:SUITE C
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5635
Practice Address - Country:US
Practice Address - Phone:559-730-9920
Practice Address - Fax:559-624-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMSS00033FOtherLEGACY