Provider Demographics
NPI:1407308489
Name:JEFFERSON DAVIS PARISH COUNCIL ON AGING
Entity Type:Organization
Organization Name:JEFFERSON DAVIS PARISH COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-824-5504
Mailing Address - Street 1:P.O. BOX 734
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546
Mailing Address - Country:US
Mailing Address - Phone:337-824-5504
Mailing Address - Fax:337-616-8622
Practice Address - Street 1:210 SOUTH STATE STREET
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546
Practice Address - Country:US
Practice Address - Phone:337-824-5504
Practice Address - Fax:337-616-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)