| Council Of Senior Tyler Countians, Inc. | |
|
504 Cherry Street Middlebourne WV 26149 | |
| (304) 758-4919 | |
| (304) 758-4680 |
| Full Name | Council Of Senior Tyler Countians, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 504 Cherry Street, Middlebourne, West Virginia |
| Authorized Official Name and Position | Tim James (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3047584919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Council Of Senior Tyler Countians, Inc. 504 Cherry Street P.o. Box 68 Middlebourne WV 26149 Ph: (304) 758-4919 | Council Of Senior Tyler Countians, Inc. 504 Cherry Street Middlebourne WV 26149 Ph: (304) 758-4919 |
| NPI Number | 1124244140 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124244140 | NPI | - | NPPES |
| 0030589000 | Medicaid | WV | |
| 0030589001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (West Virginia) | Primary |