Organization
RESCARE
Active
Other names
VOCA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LENA STREET (EXECUTIVE DIRECTOR)
(304) 583-8675
Entity
Organization
Contact information
Practice address
165 PROCTOR BOTTOM, AMHERSTDALE, WV 25607
(304) 583-7079
(304) 583-7085
Mailing address
PO BOX 1560, PRINCETON, WV 24740-1560
(304) 487-0788
(304) 487-2455
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
346
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005258020
—
WV
Enumeration date
12/22/2006
Last updated
08/22/2020
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