Provider Demographics
NPI:1548450380
Name:CRAWFORD COUNTY COUNCIL ON AGING, INC.
Entity type:Organization
Organization Name:CRAWFORD COUNTY COUNCIL ON AGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-562-3050
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-0166
Mailing Address - Country:US
Mailing Address - Phone:419-562-3050
Mailing Address - Fax:419-562-0759
Practice Address - Street 1:200 S SPRING ST
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2227
Practice Address - Country:US
Practice Address - Phone:419-562-3050
Practice Address - Fax:419-562-0759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0808200Medicaid