1528210689 NPI number — TASK FORCE ON DEOMESTIC VIOLENCE, 'HOPE, INC'

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528210689 NPI number — TASK FORCE ON DEOMESTIC VIOLENCE, 'HOPE, INC'

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TASK FORCE ON DEOMESTIC VIOLENCE, 'HOPE, INC'
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528210689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 626
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRMONT
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-367-1100
Provider Business Mailing Address Fax Number:
304-367-0362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 JACKSON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRMONT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-367-1100
Provider Business Practice Location Address Fax Number:
304-367-0362
Provider Enumeration Date:
10/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SUTTON
Authorized Official First Name:
HARRIET
Authorized Official Middle Name:
MILLER
Authorized Official Title or Position:
FINANCIAL MANAGER
Authorized Official Telephone Number:
304-367-1100

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10300 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0023902000 . This is a "OLD IDENTIFICATION NUMBER UNDER UNISYS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com