Provider Demographics
NPI:1972937290
Name:BENZIE COUNTY COUNCIL ON AGING, INC
Entity Type:Organization
Organization Name:BENZIE COUNTY COUNCIL ON AGING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DURAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-525-0600
Mailing Address - Street 1:10542 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HONOR
Mailing Address - State:MI
Mailing Address - Zip Code:49640-9461
Mailing Address - Country:US
Mailing Address - Phone:231-525-0600
Mailing Address - Fax:231-325-4855
Practice Address - Street 1:10542 MAIN ST
Practice Address - Street 2:
Practice Address - City:HONOR
Practice Address - State:MI
Practice Address - Zip Code:49640-9461
Practice Address - Country:US
Practice Address - Phone:231-525-0600
Practice Address - Fax:231-325-4855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health