Provider Demographics
NPI:1215186119
Name:PIERCE COUNTY OFFICE ON AGING
Entity type:Organization
Organization Name:PIERCE COUNTY OFFICE ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGING AND ADRC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-273-6780
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:WI
Mailing Address - Zip Code:54011-0540
Mailing Address - Country:US
Mailing Address - Phone:715-273-6780
Mailing Address - Fax:715-273-6863
Practice Address - Street 1:412 W KINNE ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:WI
Practice Address - Zip Code:54011-9230
Practice Address - Country:US
Practice Address - Phone:715-273-6780
Practice Address - Fax:715-273-6863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIERCE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)