Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Other names
Washington District Elementary School Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORA L POTASNIK (CREDENTIALING COORDINATOR)
(304) 561-5319
Entity
Organization
Contact information
Practice address
5078 TALLMANSVILLE RD, BUCKHANNON, WV 26201-1687
(304) 924-6262
(304) 924-5460
Mailing address
5078 TALLMANSVILLE RD, BUCKHANNON, WV 26201-1687
(304) 924-6262
(304) 924-5460
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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