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General NPI Number Information
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NPI Number | 1912162082
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Entity Type | Organization
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Legal Business Name | HARRISON COUNTY SOCIETY FOR CRIPPLED CHILDREN AND ADULTS
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 171LIBERTY AVE
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City | CLARKSBURG
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State | WV
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Zip | 26301-0000
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Country | US
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Telephone | 304-624-5009
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Fax | 304-624-5107
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Provider Business Mailing Address
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Address Line | 171LIBERTY AVE
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City | CLARKSBURG
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State | WV
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Zip | 26301-0000
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Country | US
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Telephone | 304-624-5009
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Fax | 304-624-5107
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LYNDA JOYCE MENENDEZ
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Credential |
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Telephone | 304-624-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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