NPIMap

Organization Active NPI

Calhoun County Senior Citizens Assoc., Inc

  • In Home Supportive Care Agency
  • Blountstown, FL
National Provider Identifier
1144510140
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
4946 Issued in FL
Legal business name
CALHOUN COUNTY SENIOR CITIZENS ASSOC., INC
Practice address
16859 NE Cayson St
Blountstown, FL 32424-2209
Phone
(850) 674-4163
Fax
(850) 674-8384
NPI assigned
Apr 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Marilyn J Russell
Title
Executive Director
Phone
(850) 674-4163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 4946 FL Primary

Addresses

Primary practice location

16859 NE Cayson St
Blountstown, FL 32424-2209

Mailing address

16859 NE Cayson St
Blountstown, FL 32424-2209
Phone (850) 674-4163

Other identifiers 2

IdentifierTypeStateIssuer
098886300MedicaidFL
098886301MedicaidFL

National Provider Directory

National Provider Directory

Locations

16859 NE Cayson St
Blountstown, FL 32424
Phone (850) 674-4163

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1144510140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16859 NE CAYSON ST",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242209",
            "telephone_number": "850-674-4163",
            "fax_number": "850-674-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16859 NE CAYSON ST",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242209",
            "telephone_number": "850-674-4163",
            "fax_number": "850-674-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALHOUN COUNTY SENIOR CITIZENS ASSOC., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "850-674-4163",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "4946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098886300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098886301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blountstown, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.