Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Parent organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Other names
Clay County Elementary School Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CARE OF WEST VIRGINIA, INC.
Authorized official
DORA L POTASNIK (CREDENTIALING)
(304) 317-7275
Entity
Organization
Contact information
Practice address
168 CHURCH ST, CLAY, WV 25043-9420
(304) 587-6045
(304) 587-6045
Mailing address
PO BOX 147, CLAY, WV 25043-0147
(304) 587-7301
(304) 587-2464
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2267-7441
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001979216
MS BCBS
WV
05
—
0035189004
—
WV
Enumeration date
05/11/2006
Last updated
05/15/2026
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