Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Active
Other names
Sutton Elementary School Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORA L POTASNIK (CREDENTIALING COORDINATOR)
(304) 587-2541
Entity
Organization
Contact information
Practice address
288 N HILL RD, SUTTON, WV 26601-1225
(304) 924-6262
(304) 924-5460
Mailing address
288 N HILL RD, SUTTON, WV 26601-1225
(304) 924-6262
(304) 924-5460
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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