Provider Demographics
NPI:1942371364
Name:DELAWARE COUNTY SENIOR CITIZEN CENTER
Entity Type:Organization
Organization Name:DELAWARE COUNTY SENIOR CITIZEN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-588-3970
Mailing Address - Street 1:3505 STONEMAN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-5305
Mailing Address - Country:US
Mailing Address - Phone:563-588-3970
Mailing Address - Fax:563-588-1952
Practice Address - Street 1:3505 STONEMAN RD STE 4
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-5305
Practice Address - Country:US
Practice Address - Phone:563-588-3970
Practice Address - Fax:563-588-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0133009Medicaid