Provider Demographics
NPI:1922451178
Name:AREA AGENCY ON AGING OF PALM BEACH/TREASURE COAST, INC.
Entity Type:Organization
Organization Name:AREA AGENCY ON AGING OF PALM BEACH/TREASURE COAST, INC.
Other - Org Name:YOUR AGING & DISABILITY RESOURCE CENTER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTREMERA-FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-684-5885
Mailing Address - Street 1:4400 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3226
Mailing Address - Country:US
Mailing Address - Phone:561-684-5885
Mailing Address - Fax:561-214-8678
Practice Address - Street 1:4400 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3226
Practice Address - Country:US
Practice Address - Phone:561-684-5885
Practice Address - Fax:561-214-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management