Organization
CHANGE INCORPORATED
Active
Other names
Family Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY RAVEAUX (CEO)
(304) 797-7733
Entity
Organization
Contact information
Practice address
1151 WASHINGTON ST, NEWELL, WV 26050
(304) 459-4010
(304) 797-7740
Mailing address
3158 WEST STREET, WEIRTON, WV 26062
(304) 459-4010
(304) 723-2195
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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