Provider Demographics
NPI:1366565996
Name:COUNCIL ON AGING OF ELKHART COUNTY, INC.
Entity type:Organization
Organization Name:COUNCIL ON AGING OF ELKHART COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:574-295-1820
Mailing Address - Street 1:2555 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-1536
Mailing Address - Country:US
Mailing Address - Phone:574-295-1820
Mailing Address - Fax:574-294-5924
Practice Address - Street 1:2555 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-1536
Practice Address - Country:US
Practice Address - Phone:574-295-1820
Practice Address - Fax:574-294-5924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health