Healthcare Provider Details

I. General information

NPI: 1700294964
Provider Name (Legal Business Name): ALECTO HEALTHCARE SERVICES FAIRMONT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 LOCUST AVE
FAIRMONT WV
26554-1435
US

IV. Provider business mailing address

1325 LOCUST AVE
FAIRMONT WV
26554-1435
US

V. Phone/Fax

Practice location:
  • Phone: 304-367-7100
  • Fax:
Mailing address:
  • Phone: 304-367-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SARRAO
Title or Position: EXECUTIVE VICE-PRESIDENT
Credential:
Phone: 949-398-8358