Organization
RESCARE WEST VIRGINIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK LANDIS (EXECUTIVE DIRECTOR)
(540) 858-2572
Entity
Organization
Contact information
Practice address
201 S WATER ST, MARTINSBURG, WV 25401-4241
(304) 263-4601
(304) 263-5701
Mailing address
PO BOX 130, 251 GORE RD, GORE, VA 22637-0130
(540) 858-2572
(540) 858-2575
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
319
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002990002
—
WV
Enumeration date
12/19/2006
Last updated
08/22/2020
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