Healthcare Provider Details

I. General information

NPI: 1134283732
Provider Name (Legal Business Name): RSCR WEST VIRGINIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 BARBOUR STREET
BUCKHANNON WV
26201-2551
US

IV. Provider business mailing address

9901 LINN STATION ROAD
LOUISVILLE KY
40223
US

V. Phone/Fax

Practice location:
  • Phone: 304-472-1350
  • Fax: 304-472-1350
Mailing address:
  • Phone: 502-394-2100
  • Fax: 502-394-2285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number44
License Number StateWV

VIII. Authorized Official

Name: MS. DEENA G. OMBRES
Title or Position: ASSOCIATE GENERAL COUNSEL & PRIVACY
Credential: ESQ.
Phone: 502-394-2387