Organization
COUNCIL ON AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER GIBSON (EXECUTIVE DIRECTOR)
(304) 294-8800
Entity
Organization
Contact information
Practice address
ROUTE 10, OLD ITMANN GRADE SCHOOL, ITMANN, WV 24847
(304) 294-8800
Mailing address
PO BOX 130, ITMANN, WV 24847-0130
(304) 294-8800
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
WV
343900000X
Non-emergency Medical Transport (VAN)
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030823000
—
WV
05
—
0030823002
—
WV
05
—
0030823003
—
WV
Enumeration date
03/08/2007
Last updated
09/11/2025
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