Organization
COSSATOT POLK COUNTY SENIOR CITIZENS, INC.
Active
Other names
Cossatot Senior Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS J RAY (EXECUTIVE DIRECTOR)
(870) 385-2373
Entity
Organization
Contact information
Practice address
7366 HIGHWAY 71 S, WICKES, AR 71973-9341
(870) 385-2373
(870) 385-2390
Mailing address
7366 HIGHWAY 71 S, WICKES, AR 71973-9341
(870) 385-2373
(870) 385-2390
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
92733
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160106753
—
AR
Enumeration date
04/22/2008
Last updated
04/22/2008
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