Provider Demographics
NPI:1942419361
Name:THE COUNCIL ON AGING OF MARTIN COUNTY INC
Entity type:Organization
Organization Name:THE COUNCIL ON AGING OF MARTIN COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-223-7800
Mailing Address - Street 1:900 SE SALERNO RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6405
Mailing Address - Country:US
Mailing Address - Phone:772-223-7800
Mailing Address - Fax:772-678-6066
Practice Address - Street 1:900 SE SALERNO RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6405
Practice Address - Country:US
Practice Address - Phone:772-223-7800
Practice Address - Fax:772-678-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
FL331251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL087651800Medicaid
FL087651801Medicaid
FL671538996Medicaid