Provider Demographics
NPI:1356890792
Name:AREA 3 SENIOR SERVICES AGENCY
Entity type:Organization
Organization Name:AREA 3 SENIOR SERVICES AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTORS CO-CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIGETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-642-6000
Mailing Address - Street 1:701 S ALLEN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-3058
Mailing Address - Country:US
Mailing Address - Phone:208-332-1769
Mailing Address - Fax:208-888-1241
Practice Address - Street 1:701 S ALLEN ST STE 100
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-3058
Practice Address - Country:US
Practice Address - Phone:208-332-1769
Practice Address - Fax:208-888-1241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management