Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Parent organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Other names
Salem Elementary School Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CARE OF WEST VIRGINIA, INC.
Authorized official
DORA L POTASNIK (CREDENTIALING)
(304) 587-2541
Entity
Organization
Contact information
Practice address
RR 1 BOX 10A, SALEM, WV 26426-9703
(304) 316-7180
(304) 924-5460
Mailing address
PO BOX 217, ROCK CAVE, WV 26234-0217
(304) 924-6262
(304) 924-5460
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WV
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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