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General NPI Number Information
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NPI Number | 1508260837
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Entity Type | Organization
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Legal Business Name | WV FAMILY SUPPORT AND REHABILITATION SERVICES
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 04/28/2024
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Provider Practice Location Address
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Address Line | 214 8TH ST.
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City | PARKERSBURG
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State | WV
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Zip | 26101
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Country | US
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Telephone | 304-917-0021
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Fax |
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Provider Business Mailing Address
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Address Line | 214 E 8TH ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-4615
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Country | US
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Telephone | 304-917-0021
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. GINA ELAINE OGWUDE
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Credential | LPC, CRC, LSW
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Telephone | 304-917-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 410
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License Number State | WV
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