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General NPI Number Information
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NPI Number | 1740306547
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Entity Type | Organization
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Legal Business Name | REM WV, INC.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 170 PADUCAH DR
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-2710
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Country | US
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Telephone | 304-455-4804
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Fax | 304-455-3786
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Provider Business Mailing Address
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Address Line | 748 MCMECHEN ST
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City | BENWOOD
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State | WV
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Zip | 26031-1100
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Country | US
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Telephone | 304-233-2141
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Fax | 304-233-3558
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Authorized Official
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Title or Position | COO
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Name | BRETT IAN COHEN
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Credential |
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Telephone | 800-388-5150
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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 |
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License Number State | WV
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