Provider Demographics
NPI:1568967115
Name:CLAIBORNE COMMUNITY ACTION ASSOC
Entity Type:Organization
Organization Name:CLAIBORNE COMMUNITY ACTION ASSOC
Other - Org Name:CLAIBORNE COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-927-3557
Mailing Address - Street 1:PO BOX 569
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-0569
Mailing Address - Country:US
Mailing Address - Phone:318-927-3557
Mailing Address - Fax:318-927-3835
Practice Address - Street 1:621 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040-3825
Practice Address - Country:US
Practice Address - Phone:318-927-3557
Practice Address - Fax:318-927-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)