Change Inc | |
114 Taylor Ave Weirton WV 26062-4635 | |
(304) 748-2828 | |
Not Available |
Full Name | Change Inc |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 114 Taylor Ave, Weirton, West Virginia |
Authorized Official Name and Position | Judy L Raveaux (CEO) |
Authorized Official Contact | 3047977733 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Change Inc 3158 West St Weirton WV 26062-4637 Ph: (304) 797-1210 | Change Inc 114 Taylor Ave Weirton WV 26062-4635 Ph: (304) 748-2828 |
NPI Number | 1619503422 |
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Provider Enumeration Date | 03/13/2020 |
Last Update Date | 03/13/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619503422 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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