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General NPI Number Information
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NPI Number | 1619146446
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN COMMUNITY ACTION COUNCIL INC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 540 5TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1908
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Country | US
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Telephone | 304-525-5151
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Fax | 304-697-8556
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Provider Business Mailing Address
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Address Line | 540 5TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1908
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Country | US
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Telephone | 304-525-5151
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Fax | 304-697-8556
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Authorized Official
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Title or Position | CEO
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Name | MR. DWIGHT COBURN
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Credential |
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Telephone | 304-525-5151
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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 | 042376
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License Number State | WV
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