Healthcare Provider Details

I. General information

NPI: 1407852957
Provider Name (Legal Business Name): SUMMERS COUNTY COUNCIL ON AGING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 2ND AVE
HINTON WV
25951-2402
US

IV. Provider business mailing address

120 2ND AVE
HINTON WV
25951-2402
US

V. Phone/Fax

Practice location:
  • Phone: 304-466-4019
  • Fax: 304-466-1890
Mailing address:
  • Phone: 304-466-4019
  • Fax: 304-466-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateWV

VIII. Authorized Official

Name: MS. CINTHIA GARRETT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-466-4019