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General NPI Number Information
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NPI Number | 1598163206
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Entity Type | Organization
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Legal Business Name | THE ARC OF THE THREE RIVERS, INC.
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 523 24TH ST
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City | DUNBAR
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State | WV
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Zip | 25064-1605
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Country | US
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Telephone | 304-768-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 QUARRIER ST STE 200
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City | CHARLESTON
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State | WV
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Zip | 25301-2329
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Country | US
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Telephone | 304-344-3403
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TIMOTHY MORRIS
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Credential |
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Telephone | 304-344-3403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 42
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License Number State | WV
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