Organization
COMMUNITY CARE OF WEST VIRGINIA,INC.
Active
Other names
United Technical Center 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
251 MARIETTA ST, CLARKSBURG, WV 26301-6313
(304) 924-6262
(304) 924-5460
Mailing address
251 MARIETTA ST, CLARKSBURG, WV 26301-6313
(304) 924-6262
(304) 924-5460
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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