Provider Demographics
NPI:1639290471
Name:AREA AGENCY ON AGING, REGION ONE, INC
Entity Type:Organization
Organization Name:AREA AGENCY ON AGING, REGION ONE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:KASUNIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-264-2255
Mailing Address - Street 1:1366 E THOMAS RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PHOENIX
Mailing Address - State:AL
Mailing Address - Zip Code:85014
Mailing Address - Country:US
Mailing Address - Phone:602-264-2255
Mailing Address - Fax:602-230-9132
Practice Address - Street 1:1366 E THOMAS RD
Practice Address - Street 2:SUITE 108
Practice Address - City:PHOENIX
Practice Address - State:AL
Practice Address - Zip Code:85014
Practice Address - Country:US
Practice Address - Phone:602-264-2255
Practice Address - Fax:602-230-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable