Provider Demographics
NPI:1932328127
Name:PECOS COUNTY COMMUNITY ACTION AGENCY INC.
Entity Type:Organization
Organization Name:PECOS COUNTY COMMUNITY ACTION AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:URETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-336-7528
Mailing Address - Street 1:PO BOX 940
Mailing Address - Street 2:
Mailing Address - City:FORT STOCKTON
Mailing Address - State:TX
Mailing Address - Zip Code:79735-0940
Mailing Address - Country:US
Mailing Address - Phone:432-336-7528
Mailing Address - Fax:432-336-7528
Practice Address - Street 1:101 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735-6717
Practice Address - Country:US
Practice Address - Phone:432-336-7528
Practice Address - Fax:432-336-7528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals