Organization
AREA CONNECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY RENEA MOHEBBI (PRESIDENT)
(304) 562-4455
Entity
Organization
Contact information
Practice address
3400 TEAYS VALLEY RD, SUITE B, HURRICANE, WV 25526-9321
(304) 562-4455
(304) 562-3303
Mailing address
PO BOX 911, HURRICANE, WV 25526-0911
(304) 562-4455
(304) 564-3303
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006314
—
WV
05
—
3810006315
—
WV
Enumeration date
02/16/2007
Last updated
08/22/2020
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