Provider Demographics
NPI:1265513501
Name:COMANCHE COUNTY NUTRITION PROJECT
Entity type:Organization
Organization Name:COMANCHE COUNTY NUTRITION PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-357-7764
Mailing Address - Street 1:PO BOX 2231
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-2231
Mailing Address - Country:US
Mailing Address - Phone:580-357-7764
Mailing Address - Fax:580-357-4774
Practice Address - Street 1:920 SW SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-1529
Practice Address - Country:US
Practice Address - Phone:580-357-7764
Practice Address - Fax:580-357-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals