Provider Demographics
NPI:1609284918
Name:MEDINA SENIOR CENTER, INC.
Entity Type:Organization
Organization Name:MEDINA SENIOR CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOALSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-741-6160
Mailing Address - Street 1:808A HARPER
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-2000
Mailing Address - Country:US
Mailing Address - Phone:830-741-6160
Mailing Address - Fax:830-741-6164
Practice Address - Street 1:808A HARPER
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-2000
Practice Address - Country:US
Practice Address - Phone:830-741-6160
Practice Address - Fax:830-741-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals