=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265652184
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAYLOR COUNTY SENIOR CITIZENS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | RR 2 BOX 514
-----------------------------------------------------
City | GRAFTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26354-9664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-265-4555
-----------------------------------------------------
Fax | 304-265-6083
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | RR 2 BOX 514
-----------------------------------------------------
City | GRAFTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-265-4555
-----------------------------------------------------
Fax | 304-265-6083
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. FRANKLIN R MAYLE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 304-265-4555
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 61551
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------