Provider Demographics
NPI:1972015535
Name:MIDLAND AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:MIDLAND AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUZIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-463-4565
Mailing Address - Street 1:2727 W 2ND ST STE 440
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4684
Mailing Address - Country:US
Mailing Address - Phone:402-463-4565
Mailing Address - Fax:402-463-1069
Practice Address - Street 1:808 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:NE
Practice Address - Zip Code:68873-2049
Practice Address - Country:US
Practice Address - Phone:308-754-5452
Practice Address - Fax:308-754-6227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDLAND AREA AGENCY ON AGING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1427245968OtherIN HOME SUPPORT CARE
NE1427245968OtherIN HOME SUPPORTIVE CARE