Organization
BUCKHANNON-UPSHUR WORK ADJUSTMENT CENTER,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEROY E. DIXON JR. (EXECUTIVE DIRECTOR)
(304) 472-4678
Entity
Organization
Contact information
Practice address
RR 2 BOX 62, BUCKHANNON, WV 26201-9503
(304) 472-4678
(304) 472-4712
Mailing address
RR 2 BOX 62, BUCKHANNON, WV 26201-9503
(304) 472-4678
(304) 472-4712
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3606005000
—
WV
Enumeration date
01/24/2008
Last updated
01/24/2008
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