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General NPI Number Information
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NPI Number | 1235518440
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Entity Type | Organization
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Legal Business Name | COMMUNITY ACCESS INCORPORATED
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 7095 SMITH CREEK RD
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City | SAINT ALBANS
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State | WV
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Zip | 25177-7519
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Country | US
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Telephone | 304-549-0561
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8885
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25303-0885
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Country | US
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Telephone | 304-549-0561
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | MARTHA MINTER
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Credential | M.S.W.
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Telephone | 304-549-0561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | DP00939412
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License Number State | WV
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