Provider Demographics
NPI:1902091077
Name:NACOGDOCHES COUNTY AGING COMMITTEE, INC.
Entity type:Organization
Organization Name:NACOGDOCHES COUNTY AGING COMMITTEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BLANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-569-6350
Mailing Address - Street 1:621 HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-5205
Mailing Address - Country:US
Mailing Address - Phone:936-569-6350
Mailing Address - Fax:936-560-1797
Practice Address - Street 1:621 HARRIS ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75964-5205
Practice Address - Country:US
Practice Address - Phone:936-569-6350
Practice Address - Fax:936-560-1797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2018-08-14
Deactivation Date:2007-09-25
Deactivation Code:
Reactivation Date:2018-08-14
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals