Provider Demographics
NPI:1902107493
Name:PRESQUE ISLE COUNTY COUNCIL ON AGING
Entity Type:Organization
Organization Name:PRESQUE ISLE COUNTY COUNCIL ON AGING
Other - Org Name:PICCA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-766-8191
Mailing Address - Street 1:6520 DARGA HWY
Mailing Address - Street 2:
Mailing Address - City:POSEN
Mailing Address - State:MI
Mailing Address - Zip Code:49776-9759
Mailing Address - Country:US
Mailing Address - Phone:989-766-8191
Mailing Address - Fax:989-766-2329
Practice Address - Street 1:6520 DARGA HWY
Practice Address - Street 2:
Practice Address - City:POSEN
Practice Address - State:MI
Practice Address - Zip Code:49776-9759
Practice Address - Country:US
Practice Address - Phone:989-766-8191
Practice Address - Fax:989-766-2329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care