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General NPI Number Information
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NPI Number | 1083814388
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Entity Type | Organization
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Legal Business Name | GOODWILL INDUSTRIES OF KANAWHA VALLEY
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 209 VIRGINIA ST W
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City | CHARLESTON
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State | WV
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Zip | 25302-2210
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Country | US
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Telephone | 304-346-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 215 VIRGINIA ST W
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City | CHARLESTON
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State | WV
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Zip | 25302-2210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIR. EMPLOYMENT, EDUCATION & TRAIN
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Name | JENNIFER L LOGAN
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Credential |
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Telephone | 304-346-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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