| Commission On Aging Family Services, Inc | |
|
111 Virginia Ave Petersburg WV 26847-1713 | |
| (304) 257-1666 | |
| (304) 257-9145 |
| Full Name | Commission On Aging Family Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 111 Virginia Ave, Petersburg, West Virginia |
| Authorized Official Name and Position | Darlene E Evans (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3042571666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commission On Aging Family Services, Inc 111 Virginia Ave Petersburg WV 26847-1713 Ph: (304) 257-1666 | Commission On Aging Family Services, Inc 111 Virginia Ave Petersburg WV 26847-1713 Ph: (304) 257-1666 |
| NPI Number | 1730529462 |
|---|---|
| Provider Enumeration Date | 06/26/2013 |
| Last Update Date | 08/31/2023 |
| Certification Date | 08/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730529462 | NPI | - | NPPES |
| 0030591000 | Medicaid | WV | |
| 3810022661 | Medicaid | WV | |
| 3810009687 | Medicaid | WV | |
| 0030591001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10359713 (West Virginia) | Primary |
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