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General NPI Number Information
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NPI Number | 1689205148
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Entity Type | Organization
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Legal Business Name | CENTER FOR SERVICE COORDINATION, LLC
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 02/03/2020
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Provider Practice Location Address
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Address Line | 630 WINCHESTER AVE STE E
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City | MARTINSBURG
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State | WV
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Zip | 25401-2102
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Country | US
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Telephone | 304-209-2001
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Fax |
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Provider Business Mailing Address
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Address Line | 630 WINCHESTER AVE STE E
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City | MARTINSBURG
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State | WV
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Zip | 25401-2102
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Country | US
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Telephone | 304-209-2001
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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 | SCOTT BAUGHMAN
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Credential | BA
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Telephone | 304-209-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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