Provider Demographics
NPI:1902206915
Name:HOUSTON COUNTY AGING SERVICE
Entity Type:Organization
Organization Name:HOUSTON COUNTY AGING SERVICE
Other - Org Name:HOUSTON COUNTY, TEXAS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-544-3255
Mailing Address - Street 1:112 E HOUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:TX
Mailing Address - Zip Code:75835-1949
Mailing Address - Country:US
Mailing Address - Phone:936-544-3255
Mailing Address - Fax:936-544-9291
Practice Address - Street 1:112 E HOUSTON AVE
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-1949
Practice Address - Country:US
Practice Address - Phone:936-544-3255
Practice Address - Fax:936-544-9291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS5170OtherHOME DELIVERED MEALS S5170