Provider Demographics
NPI:1124428842
Name:MARTIN SENIOR CITIZENS CENTER, INC.
Entity type:Organization
Organization Name:MARTIN SENIOR CITIZENS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOLUNTEER TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-594-2625
Mailing Address - Street 1:POST OFFICE BOX 1999
Mailing Address - Street 2:400 WALKER STREET
Mailing Address - City:TRINITY
Mailing Address - State:TX
Mailing Address - Zip Code:75862
Mailing Address - Country:US
Mailing Address - Phone:936-594-2625
Mailing Address - Fax:936-594-7456
Practice Address - Street 1:400 WALKER STREET
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:TX
Practice Address - Zip Code:75862
Practice Address - Country:US
Practice Address - Phone:936-594-2625
Practice Address - Fax:936-594-7456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD001000822OtherTX DADS