Organization
COMMUNITY ACTION SOUTH EASTERN WV
Active
Other names
CASE WV
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA JOHNSON RN (PROGRAM DIRECTOR)
(304) 323-8398
Entity
Organization
Contact information
Practice address
307 FEDERAL ST, SUITE 323, BLUEFIELD, WV 24701-3063
(304) 323-8398
(304) 324-8791
Mailing address
307 FEDERAL ST, SUITE 323, BLUEFIELD, WV 24701-3063
(304) 327-3506
(304) 327-8822
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004732
—
WV
01
—
93564
UNICARE PROVIDER NUMBER
WV
Enumeration date
09/25/2006
Last updated
08/22/2020
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