Organization
UNITED SUMMIT CENTER INC-WAVIER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PRICE (AUTHORIZAED OFFICIAL)
(304) 623-5661
Entity
Organization
Contact information
Practice address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 623-5661
(304) 623-2180
Mailing address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 623-5661
(304) 623-2180
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
20
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005239000
—
WV
Enumeration date
05/04/2007
Last updated
04/30/2018
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