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General NPI Number Information
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NPI Number | 1508205436
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Entity Type | Organization
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Legal Business Name | COMMISSION ON AGING FAMILY SERVICES, INC
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 111 VIRGINIA AVE
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City | PETERSBURG
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State | WV
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Zip | 26847-1713
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Country | US
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Telephone | 304-257-1666
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Fax | 304-257-1945
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Provider Business Mailing Address
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Address Line | 111 VIRGINIA AVE
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City | PETERSBURG
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State | WV
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Zip | 26847-1713
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Country | US
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Telephone | 304-257-1666
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Fax | 304-257-1945
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DARLENE E EVANS
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Credential |
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Telephone | 304-257-1666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 10359713
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License Number State | WV
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