Healthcare Provider Details

I. General information

NPI: 1538232368
Provider Name (Legal Business Name): LEWIS COUNTY SENIOR CITIZENS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 W 2ND ST
WESTON WV
26452-1665
US

IV. Provider business mailing address

171 W 2ND ST
WESTON WV
26452-1665
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-5738
  • Fax: 304-269-7329
Mailing address:
  • Phone: 304-269-5738
  • Fax: 304-269-7329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DINAH MILLS
Title or Position: DIRECTOR
Credential:
Phone: 304-269-5738