Healthcare Provider Details

I. General information

NPI: 1205990082
Provider Name (Legal Business Name): NEW HIRE RESIDENTIAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BROAD ST
SUMMERSVILLE WV
26651-1708
US

IV. Provider business mailing address

5638 LEGATE DR
ROANOKE VA
24019-3354
US

V. Phone/Fax

Practice location:
  • Phone: 304-872-9531
  • Fax: 304-872-0757
Mailing address:
  • Phone: 540-815-0988
  • Fax: 304-205-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number138
License Number StateWV

VIII. Authorized Official

Name: CASEY LYNN CROUSE
Title or Position: CEO
Credential:
Phone: 540-815-0988