Provider Demographics
NPI:1386764603
Name:AREA AGENCY ON AGING REGION X
Entity type:Organization
Organization Name:AREA AGENCY ON AGING REGION X
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-781-7562
Mailing Address - Street 1:2701 BIRD AVE
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1615
Mailing Address - Country:US
Mailing Address - Phone:417-781-7562
Mailing Address - Fax:417-781-1609
Practice Address - Street 1:2701 BIRD AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1615
Practice Address - Country:US
Practice Address - Phone:417-781-7562
Practice Address - Fax:417-781-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals