Healthcare Provider Details

I. General information

NPI: 1669557708
Provider Name (Legal Business Name): POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE BLUE STREET
ROMNEY WV
26757
US

IV. Provider business mailing address

ONE BLUE STREET
ROMNEY WV
26757
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-3861
  • Fax: 304-822-4297
Mailing address:
  • Phone: 304-822-3861
  • Fax: 304-822-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID PLOWRIGHT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-822-3861