Organization
VERNON COUNCIL ON AGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIS L. CHANCE (EXE. DIRECTOR)
(337) 239-4361
Entity
Organization
Contact information
Practice address
200 N 3RD ST, LEESVILLE, LA 71446-4016
(337) 239-4361
(337) 239-0186
Mailing address
200 N 3RD ST, LEESVILLE, LA 71446-4016
(337) 239-4361
(337) 239-0186
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1378411
—
LA
Enumeration date
05/17/2007
Last updated
08/22/2020
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