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Organization

CALHOUN COUNTY SENIOR CITIZENS ASSOC., INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARILYN J RUSSELL (EXECUTIVE DIRECTOR)
(850) 674-4163
Entity
Organization

Contact information

Practice address
16859 NE CAYSON ST, BLOUNTSTOWN, FL 32424-2209
(850) 674-4163
(850) 674-8384
Mailing address
16859 NE CAYSON ST, BLOUNTSTOWN, FL 32424-2209
(850) 674-4163
(850) 674-8384

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
4946
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
098886300
FL
05
098886301
FL
Enumeration date
04/11/2011
Last updated
10/08/2014
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