Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Other names
Union Elementary School Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORA L POTASNIK (CREDENTIALING COORDINATOR)
(304) 561-5319
Entity
Organization
Contact information
Practice address
481 HEAVNER GROVE RD, BUCKHANNON, WV 26201-4859
(304) 924-6262
(304) 924-5460
Mailing address
481 HEAVNER GROVE RD, BUCKHANNON, WV 26201-4859
(304) 924-6262
(304) 924-5460
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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