Provider Demographics
NPI:1558405530
Name:YOUNG COUNTY OLNEY SENIOR CUB CENTER INC.
Entity Type:Organization
Organization Name:YOUNG COUNTY OLNEY SENIOR CUB CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JERRI
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-564-2782
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76374-0216
Mailing Address - Country:US
Mailing Address - Phone:940-564-2782
Mailing Address - Fax:
Practice Address - Street 1:302 S AVE B
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:TX
Practice Address - Zip Code:76374-0216
Practice Address - Country:US
Practice Address - Phone:940-564-2782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332U00000X332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals