# THE COUNCIL OF SENIOR CITIZENS OF GILMER COUNTY, INC-PCA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205253069
- **Authorized official:** SALLIE MATHESS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (304) 462-5761

## Contact information

- **Practice address:** 720 N LEWIS ST, GLENVILLE, WV 26351-1319
- **Practice address phone:** (304) 462-5761
- **Practice address fax:** (304) 462-8239
- **Mailing address:** 720 N LEWIS ST, GLENVILLE, WV 26351-1319
- **Mailing address phone:** (304) 462-5761
- **Mailing address fax:** (304) 462-8239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 1035-9481 | WV | Yes |

## Other

- **Enumeration date:** 03/18/2014
- **Last updated:** 03/18/2014