Provider Demographics
NPI:1760603880
Name:OCEANA COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:OCEANA COUNTY COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PREMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-873-4461
Mailing Address - Street 1:621 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HART
Mailing Address - State:MI
Mailing Address - Zip Code:49420-1144
Mailing Address - Country:US
Mailing Address - Phone:231-873-4461
Mailing Address - Fax:231-873-5645
Practice Address - Street 1:621 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1144
Practice Address - Country:US
Practice Address - Phone:231-873-4461
Practice Address - Fax:231-873-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health