Provider Demographics
NPI:1407988330
Name:CHILDRESS MEALS ON WHEELS
Entity Type:Organization
Organization Name:CHILDRESS MEALS ON WHEELS
Other - Org Name:MEALS ON WHEELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-937-6655
Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:CHILDRESS FAIR PARK
Mailing Address - City:CHILDRESS
Mailing Address - State:TX
Mailing Address - Zip Code:79201-1073
Mailing Address - Country:US
Mailing Address - Phone:940-937-6655
Mailing Address - Fax:
Practice Address - Street 1:CHILDRESS FAIR PARK
Practice Address - Street 2:CHILDRESS FAIR PARK
Practice Address - City:CHILDRESS
Practice Address - State:TX
Practice Address - Zip Code:79201-1073
Practice Address - Country:US
Practice Address - Phone:940-937-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals