Organization
COUNCIL OF SENIOR TYLER COUNTIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM JAMES (DIRECTOR)
(304) 758-4919
Entity
Organization
Contact information
Practice address
504 CHERRY STREET, MIDDLEBOURNE, WV 26149
(304) 758-4919
(304) 758-4860
Mailing address
PO BOX 68, MIDDLEBOURNE, WV 26149-0068
(304) 758-4919
(304) 758-4860
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030589000
—
WV
Enumeration date
12/04/2007
Last updated
12/04/2007
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