Organization
CABIN CREEK HEALTH CENTER, INC.
Active
Other names
Kanawha City Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RUSSELL (ADMINISTRATIVE ASSISTANT)
(304) 734-2040
Entity
Organization
Contact information
Practice address
4602 MACCORKLE AVE SE, CHARLESTON, WV 25304-1848
(304) 734-2040
(304) 734-2047
Mailing address
PO BOX 70, DAWES, WV 25054-0070
(304) 734-2040
(304) 734-2047
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1041-6374
WV
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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