Organization
RESCARE
Active
Other names
VOCA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE SHAW (EXECUTIVE DIRECTOR)
(304) 645-1110
Entity
Organization
Contact information
Practice address
308 JUDYVILLE RD, LEWISBURG, WV 24901-1215
(304) 647-3211
Mailing address
208 S COURT STREET, LEWSIBURG, WV 24901-1316
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
325
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005258018
—
WV
Enumeration date
12/22/2006
Last updated
08/22/2020
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