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General NPI Number Information
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NPI Number | 1255476511
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Entity Type | Organization
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Legal Business Name | KANAWHA VALLEY SENIOR SERVICES
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1710 PENNSYLVANIA AVE
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City | CHARLESTON
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State | WV
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Zip | 25302-3934
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Country | US
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Telephone | 304-348-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 PENNSYLVANIA AVE
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City | CHARLESTON
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State | WV
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Zip | 25302-3934
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Country | US
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Telephone | 304-348-0707
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Fax | 304-348-6432
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MELANIE HIRST
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Credential |
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Telephone | 304-348-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | WV
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