Provider Demographics
NPI:1558540104
Name:HAMILTON COUNT COUNCIL ON AGING
Entity Type:Organization
Organization Name:HAMILTON COUNT COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANG.
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-792-1136
Mailing Address - Street 1:1509 S.W. 1ST ST.
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:FL
Mailing Address - Zip Code:32052
Mailing Address - Country:US
Mailing Address - Phone:386-792-1136
Mailing Address - Fax:386-792-3838
Practice Address - Street 1:1509 S.W. 1ST ST.
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:FL
Practice Address - Zip Code:32052
Practice Address - Country:US
Practice Address - Phone:386-792-1136
Practice Address - Fax:386-792-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management