Provider Demographics
NPI:1821125352
Name:CALLAHAN COUNTY AGING SERVICES
Entity Type:Organization
Organization Name:CALLAHAN COUNTY AGING SERVICES
Other - Org Name:CALLAHAN COUNTY NUTRITION PROJECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOOREHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-854-5858
Mailing Address - Street 1:400 4TH ST
Mailing Address - Street 2:STE 302 COURTHOUSE
Mailing Address - City:BAIRD
Mailing Address - State:TX
Mailing Address - Zip Code:79504
Mailing Address - Country:US
Mailing Address - Phone:325-854-5858
Mailing Address - Fax:325-854-5859
Practice Address - Street 1:400 4TH ST
Practice Address - Street 2:STE 302 COURTHOUSE
Practice Address - City:BAIRD
Practice Address - State:TX
Practice Address - Zip Code:79504
Practice Address - Country:US
Practice Address - Phone:325-854-5858
Practice Address - Fax:325-854-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0001744100OtherCCAD HDM (DADS)
TX001012996OtherCBA HDM (DADS)