Provider Demographics
NPI:1861609315
Name:ALLEN COUNCIL ON AGING, INC.
Entity type:Organization
Organization Name:ALLEN COUNCIL ON AGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ROBERTS
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-335-3195
Mailing Address - Street 1:602 E 5TH AVE
Mailing Address - Street 2:POST OFFICE DRAWER EL
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-2921
Mailing Address - Country:US
Mailing Address - Phone:318-335-3195
Mailing Address - Fax:318-335-3199
Practice Address - Street 1:602 E 5TH AVE
Practice Address - Street 2:PO DRAWER EL
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-2921
Practice Address - Country:US
Practice Address - Phone:318-335-3195
Practice Address - Fax:318-335-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1612219Medicaid