Provider Demographics
NPI:1932643871
Name:CENTRAL MISSOURI AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:CENTRAL MISSOURI AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-443-5823
Mailing Address - Street 1:1121 BUSINESS LOOP 70 E
Mailing Address - Street 2:FLR 2A
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-4600
Mailing Address - Country:US
Mailing Address - Phone:573-443-5823
Mailing Address - Fax:
Practice Address - Street 1:1121 BUSINESS LOOP 70 E
Practice Address - Street 2:FLR 2A
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-4600
Practice Address - Country:US
Practice Address - Phone:573-443-5823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOM279925309Medicaid
MOM289925307Medicaid