Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Parent organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Other names
Green Bank Elementary-Middle School Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CARE OF WEST VIRGINIA, INC.
Authorized official
RICHARD G SIMON (CEO)
(304) 924-6262
Entity
Organization
Contact information
Practice address
RR 1 BOX 5, GREEN BANK, WV 24944-9703
(304) 456-4865
(304) 456-5162
Mailing address
RR 1 BOX 5, GREEN BANK, WV 24944-9703
(304) 456-4865
(304) 456-5162
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/17/2012
Last updated
08/17/2012
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