Provider Demographics
NPI:1952721987
Name:MONROE COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:MONROE COUNTY COUNCIL ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:POWER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:304-753-4384
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:LINDSIDE
Mailing Address - State:WV
Mailing Address - Zip Code:24951-0149
Mailing Address - Country:US
Mailing Address - Phone:304-753-4384
Mailing Address - Fax:
Practice Address - Street 1:8395 SENECA TRAIL SOUTH
Practice Address - Street 2:
Practice Address - City:LINDSIDE
Practice Address - State:WV
Practice Address - Zip Code:24951-0149
Practice Address - Country:US
Practice Address - Phone:304-753-4384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1025-2097251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable