Provider Demographics
NPI:1336557594
Name:OTTAWA COUNTY SENIOR RESOURCES
Entity Type:Organization
Organization Name:OTTAWA COUNTY SENIOR RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-898-6459
Mailing Address - Street 1:8180 W STATE ROUTE 163
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-8855
Mailing Address - Country:US
Mailing Address - Phone:419-898-6459
Mailing Address - Fax:567-262-3617
Practice Address - Street 1:8180 W STATE ROUTE 163
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-8855
Practice Address - Country:US
Practice Address - Phone:419-898-6459
Practice Address - Fax:567-262-3617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OTTAWA COUNTY COMMISSIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals