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General NPI Number Information
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NPI Number | 1821421991
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Entity Type | Organization
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Legal Business Name | CARRIAGE INN HOME CARE OF WEST VIRGINIA, INC.
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 11/28/2014
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Provider Practice Location Address
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Address Line | 210 THREE SPRINGS DR SUITE 2
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City | WEIRTON
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State | WV
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Zip | 26062-3815
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Country | US
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Telephone | 304-914-4473
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Fax | 304-914-3090
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Provider Business Mailing Address
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Address Line | 210 THREE SPRINGS DR SUITE 2
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City | WEIRTON
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State | WV
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Zip | 26062-3815
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Country | US
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Telephone | 304-914-4473
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Fax | 304-914-3090
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | LISA ANN BROWN
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Credential | RN
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Telephone | 440-813-3931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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