Organization
NICHOLAS COMMUNITY ACTION PARTNERSHIP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A JARROLL (PRESIDENT)
(304) 872-1162
Entity
Organization
Contact information
Practice address
1205 BROAD ST, SUMMERSVILLE, WV 26651-1805
(304) 872-1162
(304) 872-5796
Mailing address
1205 BROAD ST, SUMMERSVILLE, WV 26651-1805
(304) 872-1162
(304) 872-5796
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
020385
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030701000
—
WV
05
—
0030701001
—
WV
Enumeration date
07/19/2005
Last updated
08/22/2020
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