MEDICARE: VOCA CORPORATION OF WEST VIRGINIA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD1600X	Developmental Disabilities Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184780629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOCA CORPORATION OF WEST VIRGINIA, INC.

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-7101
Country	:	US
Telephone Number	:	800-866-0860
Fax Number	:	502-394-2159

Provider Business Practice Location Address
First Line	:	712 MERCER ST
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24740-3114
Country	:	US
Telephone Number	:	304-431-3533
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT & DIRECTOR
Name	:	MS. LES DYE
Credential	:
Telephone Number	:	304-210-2481

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	10/09/2023

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