Organization
RESCARE WEST VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK LANDIS (EXECUTIVE DIRECTOR)
(540) 858-2572
Entity
Organization
Contact information
Practice address
1207 W VIRGINIA AVE, MARTINSBURG, WV 25401-1643
(304) 263-4871
(304) 263-4871
Mailing address
PO BOX 130, 251 GORE RD, GORE, VA 22637-0130
(540) 858-2572
(540) 858-2575
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
337
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003445001
—
WV
Enumeration date
12/26/2006
Last updated
08/22/2020
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