1073605283 NPI number — CAREGIVING AND ADVOCACY FOR THE RURAL ELDERLY INC

Table of content: (NPI 1073605283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073605283 NPI number — CAREGIVING AND ADVOCACY FOR THE RURAL ELDERLY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREGIVING AND ADVOCACY FOR THE RURAL ELDERLY 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:
6
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:
1073605283
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 186
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUCKHANNON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26201-0186
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-472-0395
Provider Business Mailing Address Fax Number:
304-472-4673

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUTTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26601-1303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-472-0395
Provider Business Practice Location Address Fax Number:
304-472-4673
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
POST
Authorized Official First Name:
EVELYN
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
304-472-0395

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  056907 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2801006000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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