Organization
COUNCIL ON AGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GIBSON (EXECUTIVE DIRECTOR)
(304) 294-8800
Entity
Organization
Contact information
Practice address
RT 10 OLD ITMANN GRADE SCHOOL, ITMANN, WV 24847
(304) 294-8800
(304) 294-8803
Mailing address
PO BOX 130, ITMANN, WV 24847-0130
(304) 294-8800
(304) 294-8803
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
WVM0004468979
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810022730
—
WV
Enumeration date
03/26/2014
Last updated
03/26/2014
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