Provider Demographics
NPI:1134767734
Name:AGING SERVICES OF WASHINGTON COUNTY
Entity type:Organization
Organization Name:AGING SERVICES OF WASHINGTON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:MANNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-228-6856
Mailing Address - Street 1:100 W BEAU ST STE 407
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 W BEAU ST STE 407
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4432
Practice Address - Country:US
Practice Address - Phone:724-228-5856
Practice Address - Fax:724-228-6985
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1002272960013Medicaid