Council of Senior Tyler Countians, Inc.

Organization Active NPI Community/Behavioral Health Agency · Middlebourne, WV

NPI 1124244140 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1124244140
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
COUNCIL OF SENIOR TYLER COUNTIANS, INC.
Practice address
504 Cherry Street
Middlebourne, WV 26149
Phone
(304) 758-4919
Fax
(304) 758-4680
NPI assigned
Apr 18, 2007
Organization subpart
No

Authorized official

Name
Tim James
Title
Executive Director
Phone
(304) 758-4919

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Council of Senior Tyler Countians Inc (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X WV Yes

Addresses

Primary practice location

504 Cherry Street
Middlebourne, WV 26149

Mailing address

504 Cherry Street
P.O. Box 68
Middlebourne, WV 26149
Phone (304) 758-4919

Other identifiers

IdentifierTypeStateIssuer
0030589000MedicaidWV
0030589001MedicaidWV

Other providers in Middlebourne, WV

All providers in Middlebourne, WV · Community/Behavioral Health Agency in West Virginia

Sources for this page

Verify at the official NPI Registry.