Healthcare Provider Details

I. General information

NPI: 1083989701
Provider Name (Legal Business Name): COMMITTEE FOR HANCOCK COUNTY SENIOR CITIZENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 GAS VALLEY ROAD
NEW CUMBERLAND WV
26047-1284
US

IV. Provider business mailing address

647 GAS VALLEY ROAD PO BOX 1284
NEW CUMBERLAND WV
26047-1284
US

V. Phone/Fax

Practice location:
  • Phone: 304-564-3801
  • Fax: 304-387-2693
Mailing address:
  • Phone: 304-564-3801
  • Fax: 304-387-2693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: E MARK KNABENSHUE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-564-3801