Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Other names
Community Care Connections of Weston
Organization subpart
No
Provider details
NPI number
Authorized official
DORA L POTASNIK (CREDENTIALING COORDINATOR)
(304) 317-7275
Entity
Organization
Contact information
Practice address
133 STAUNTON DR, WESTON, WV 26452-5604
(304) 473-5600
(304) 472-1341
Mailing address
133 STAUNTON DR, WESTON, WV 26452-5604
(304) 473-5600
(304) 472-1341
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
12/07/2022
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