Provider Demographics
NPI:1295952869
Name:CHARLES CITY MEALS ON WHEELS, INC.
Entity type:Organization
Organization Name:CHARLES CITY MEALS ON WHEELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN MEALS ON WHEELS BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEZWAAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-228-3397
Mailing Address - Street 1:200 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616-2715
Mailing Address - Country:US
Mailing Address - Phone:641-228-3397
Mailing Address - Fax:
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-2715
Practice Address - Country:US
Practice Address - Phone:641-228-3397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals