Organization
COMMUNITY CARE OF WEST VIRGINIA INC
Active
Other names
Clay County High School Wellness Center, Clay High School Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORA L POTASNIK (CREDENTIALING COORDINATOR)
(304) 317-7275
Entity
Organization
Contact information
Practice address
ONE PANTHER DRIVE, CLAY, WV 25043-0729
(304) 587-2867
(304) 587-2867
Mailing address
249 SKIDMORE LN, SUTTON, WV 26601-9272
(304) 317-7275
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2267-4838
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001979216
MS BCBS
WV
05
—
0035189006
—
WV
05
—
1992755789
—
WV
Enumeration date
05/11/2006
Last updated
01/13/2026
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