=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669557708
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | ONE BLUE STREET
-----------------------------------------------------
City | ROMNEY
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-822-3861
-----------------------------------------------------
Fax | 304-822-4297
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | ONE BLUE STREET
-----------------------------------------------------
City | ROMNEY
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-822-3861
-----------------------------------------------------
Fax | 304-822-4297
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. DAVID PLOWRIGHT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 304-822-3861
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------