Provider Demographics
NPI:1952501157
Name:WISE COUNTY COMMITTEE ON AGING ,INC.
Entity Type:Organization
Organization Name:WISE COUNTY COMMITTEE ON AGING ,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-627-5329
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:300 NORTH TRINITY STREET SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-0903
Mailing Address - Country:US
Mailing Address - Phone:940-627-5329
Mailing Address - Fax:940-627-1945
Practice Address - Street 1:300 N TRINITY ST STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-1464
Practice Address - Country:US
Practice Address - Phone:940-627-5329
Practice Address - Fax:940-627-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable