Provider Demographics
NPI:1831647155
Name:BRAZOS VALLEY COMMUNITY ACTION PROGRAMS
Entity Type:Organization
Organization Name:BRAZOS VALLEY COMMUNITY ACTION PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-595-2801
Mailing Address - Street 1:PO BOX 4128
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77805-4128
Mailing Address - Country:US
Mailing Address - Phone:979-595-2801
Mailing Address - Fax:979-595-2810
Practice Address - Street 1:203 W 30TH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-6923
Practice Address - Country:US
Practice Address - Phone:979-823-2203
Practice Address - Fax:979-775-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals