Organization
CLAY COUNTY COUNCIL ON AGING, INC.
Active
Other names
(DBA) Council on Aging of Clay County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW DECANDIS (EXECUTIVE DIRECTOR)
(904) 531-5020
Entity
Organization
Contact information
Practice address
604 WALNUT ST, GREEN COVE SPRINGS, FL 32043-3322
(904) 284-5977
(904) 284-0296
Mailing address
604 WALNUT STREET, GREEN COVE SPRINGS, FL 32043-3322
(904) 284-3134
(904) 284-0296
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
5666
FL
302R00000X
Health Maintenance Organization
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070035500
—
FL
Enumeration date
05/16/2008
Last updated
01/26/2015
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