Healthcare Provider Details

I. General information

NPI: 1497898456
Provider Name (Legal Business Name): GREENBRIER COUNTY COMMITTEE ON AGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 GREENBRIER STREET
RUPERT WV
25984
US

IV. Provider business mailing address

PO BOX 556
RUPERT WV
25984-0556
US

V. Phone/Fax

Practice location:
  • Phone: 304-392-5138
  • Fax: 304-392-5969
Mailing address:
  • Phone: 304-392-5138
  • Fax: 304-392-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateWV

VIII. Authorized Official

Name: MS. CINDA KINSEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-392-5138