# CABIN CREEK HEALTH CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CABIN CREEK HEALTH CENTER, INC.
- **Other names:** Cabin Creek Health Center, Inc. at KCHD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063932929
- **Legal business name:** CABIN CREEK HEALTH CENTER, INC.
- **Authorized official:** JENNIFER RUSSELL (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (304) 734-2040

## Contact information

- **Practice address:** 108 LEE ST E, CHARLESTON, WV 25301-1506
- **Practice address phone:** (304) 734-2040
- **Practice address fax:** (304) 734-2047
- **Mailing address:** PO BOX 70, DAWES, WV 25054-0070
- **Mailing address phone:** (304) 734-2040
- **Mailing address fax:** (304) 734-2047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/22/2017
- **Last updated:** 06/22/2017