Organization
RALEIGH COUNTY COMMISSION ON AGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK TANNER (EXECUTIVE DIRECTOR)
(304) 255-1397
Entity
Organization
Contact information
Practice address
1614 S KANAWHA ST, BECKLEY, WV 25801-6239
(304) 255-1397
(304) 252-9360
Mailing address
1614 S KANAWHA ST, BECKLEY, WV 25801-6239
(304) 255-1397
(304) 252-9360
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
WV
3747A0650X
Attendant Care Provider
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619185147
—
WV
05
—
3810022491
—
WV
Enumeration date
04/05/2012
Last updated
04/05/2012
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