Organization
MULBERRY STREET MANAGEMENT SERVICES, INC.
Active
Other names
Coordinating Council for Independent Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY S PLEVICH (CFO)
(304) 291-9066
Entity
Organization
Contact information
Practice address
1097 GREENBAG RD, MORGANTOWN, WV 26508-1532
(304) 291-9066
(304) 291-2119
Mailing address
1097 GREENBAG RD, MORGANTOWN, WV 26508-1532
(304) 291-9066
(304) 291-2119
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
310
WV
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030447003
—
WV
Enumeration date
09/21/2006
Last updated
08/09/2007
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