Provider Demographics
NPI:1679941116
Name:CITY OF CROSS PLAINS
Entity Type:Organization
Organization Name:CITY OF CROSS PLAINS
Other - Org Name:CROSS PLAINS SENIOR CITIZENS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-725-6114
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:CROSS PLAINS
Mailing Address - State:TX
Mailing Address - Zip Code:76443-0144
Mailing Address - Country:US
Mailing Address - Phone:254-725-6521
Mailing Address - Fax:254-270-0055
Practice Address - Street 1:108 NORTH MAIN STREET.
Practice Address - Street 2:
Practice Address - City:CROSS PLAINS
Practice Address - State:TX
Practice Address - Zip Code:76443
Practice Address - Country:US
Practice Address - Phone:254-725-6521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD001016430Medicaid
TXD001016431Medicaid