Healthcare Provider Details

I. General information

NPI: 1285095513
Provider Name (Legal Business Name): EMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BELL STREET
ELKINS WV
26241
US

IV. Provider business mailing address

100 BELL STREET
ELKINS WV
26241
US

V. Phone/Fax

Practice location:
  • Phone: 304-637-8000
  • Fax: 304-636-4694
Mailing address:
  • Phone: 304-637-8000
  • Fax: 304-636-4694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number195
License Number StateWV

VIII. Authorized Official

Name: REBECCA SANDERS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CEO
Phone: 304-637-8000