Provider Demographics
NPI:1942442082
Name:ARROWHEAD ECONOMIC OPPORTUNITY AGENCY
Entity Type:Organization
Organization Name:ARROWHEAD ECONOMIC OPPORTUNITY AGENCY
Other - Org Name:AEOA MEALS ON WHEELS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-749-2912
Mailing Address - Street 1:702 SOUTH THIRD AVENUE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792
Mailing Address - Country:US
Mailing Address - Phone:218-749-2912
Mailing Address - Fax:218-749-2944
Practice Address - Street 1:702 SOUTH THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792
Practice Address - Country:US
Practice Address - Phone:218-749-2912
Practice Address - Fax:218-749-2944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care