Organization
DESOTO COUNCIL ON THE AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTHA B JONES (EXECUTIVE DIRECTOR)
(318) 872-0671
Entity
Organization
Contact information
Practice address
1004 POLK ST, MANSFIELD, LA 71052-2523
(318) 872-0671
(318) 872-9473
Mailing address
1004 POLK ST, P.O. BOX 996, MANSFIELD, LA 71052-2523
(318) 872-0671
(318) 872-9473
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1393444
—
LA
Enumeration date
06/13/2007
Last updated
08/22/2020
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