Healthcare Provider Details

I. General information

NPI: 1457416034
Provider Name (Legal Business Name): RESCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 BEECH ST
KENOVA WV
25530-1138
US

IV. Provider business mailing address

1802 BEECH ST
KENOVA WV
25530-1138
US

V. Phone/Fax

Practice location:
  • Phone: 304-453-3239
  • Fax: 304-453-3173
Mailing address:
  • Phone: 304-453-3239
  • Fax: 304-453-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSH CALDWELL
Title or Position: ASSISTANT EXECUTIVE DIRECTOR
Credential:
Phone: 304-522-3548