Organization
CABIN CREEK HEALTH CENTER, INC.
Active
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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