Organization
PACE ENTERPRISES OF WEST VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C GREG MORRIS (CHIEF EXECUTIVE OFFICE)
(304) 983-7223
Entity
Organization
Contact information
Practice address
889 MYLAN PARK LN, MORGANTOWN, WV 26501-2413
(304) 983-7223
(304) 983-2441
Mailing address
889 MYLAN PARK LN, MORGANTOWN, WV 26501-2413
(304) 983-7223
(304) 983-2441
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005357000
WV MEDICAID MMIS PROVIDER ID NUMBER
WV
01
—
1356449375
NPI NUMBER
WV
Enumeration date
10/28/2014
Last updated
10/28/2014
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