Organization
COUNCIL OF SENIOR TYLER COUNTIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM JAMES (EXECUTIVE DIRECTOR)
(304) 758-4919
Entity
Organization
Contact information
Practice address
504 CHERRY STREET, MIDDLEBOURNE, WV 26149
(304) 758-4919
(304) 758-4680
Mailing address
504 CHERRY STREET, P.O. BOX 68, MIDDLEBOURNE, WV 26149
(304) 758-4919
(304) 758-4680
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030589000
—
WV
05
—
0030589001
—
WV
Enumeration date
04/18/2007
Last updated
07/21/2022
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