Healthcare Provider Details

I. General information

NPI: 1750615894
Provider Name (Legal Business Name): VOCA CORPORATION OF WEST VIRGINIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1618 BUCKHANNON PIKE
NUTTER FORT WV
26301-4465
US

IV. Provider business mailing address

9901 LINN STATION RD
LOUISVILLE KY
40223-3808
US

V. Phone/Fax

Practice location:
  • Phone: 304-326-0140
  • Fax:
Mailing address:
  • Phone: 800-866-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWV

VIII. Authorized Official

Name: DEENA OMBRES
Title or Position: PRIVACY OFFICER
Credential:
Phone: 502-394-2387