Organization
DODDRIDGE CO. SENIOR CITIZENS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN TRAVIS (DIRECTOR)
(304) 873-2061
Entity
Organization
Contact information
Practice address
403 W MAIN ST, WEST UNION, WV 26456-1127
(304) 873-2061
Mailing address
403 W MAIN ST, WEST UNION, WV 26456-1127
(304) 873-2061
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030953000
—
WV
Enumeration date
04/17/2007
Last updated
11/14/2022
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