Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Other names
Community Care of Weston II
Organization subpart
No
Provider details
NPI number
Authorized official
DORA L POTASNIK (CREDENTIALING COORDINATOR)
(304) 561-5319
Entity
Organization
Contact information
Practice address
107 STAUNTON DR, WESTON, WV 26452-5604
(304) 269-2022
(304) 269-2037
Mailing address
249 SKIDMORE LN, SUTTON, WV 26601-9272
(304) 561-5319
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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