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General NPI Number Information
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NPI Number | 1063576700
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Entity Type | Organization
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Legal Business Name | RSCR WEST VIRGINIA, INC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 26 DAVIS ST
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City | PETERSBURG
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State | WV
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Zip | 26847-1535
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Country | US
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Telephone | 304-257-4474
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Fax | 304-257-1936
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Provider Business Mailing Address
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Address Line | 9901 LINN STATION RD
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City | LOUISVILLE
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State | KY
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Zip | 40223-3808
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Country | US
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Telephone | 800-866-0860
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Fax |
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Authorized Official
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Title or Position | ASSOC. GEN. COUNSEL/PRIVACY OFFICER
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Name | MS. DEENA G. OMBRES
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Credential |
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Telephone | 502-394-2387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 383
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License Number State | WV
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