Organization
PRIDE COMMUNITY SERVICES, INC.
Active
Other names
PRIDE IN LOGAN COUNTY, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD JONES (EXECUTIVE DIRECTOR)
(304) 752-6868
Entity
Organization
Contact information
Practice address
699 STRATTON ST, LOGAN, WV 25601-4020
(304) 752-2686
(304) 752-1047
Mailing address
PO BOX 1346, LOGAN, WV 25601-1346
(304) 752-6868
(304) 752-1047
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810022733
—
WV
Enumeration date
03/26/2012
Last updated
04/11/2012
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