NPIMap

Organization Active NPI

Senior Life Services of Morgan County, Inc

  • Home Health Agency
  • Berkeley Springs, WV
National Provider Identifier
1134599616
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SENIOR LIFE SERVICES OF MORGAN COUNTY, INC
Practice address
106 Sand Mine Rd
Suite #1
Berkeley Springs, WV 25411-7457
Phone
(304) 258-3096
Fax
(304) 258-3190
NPI assigned
Sep 28, 2015
Last updated
Sep 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Joel R Tuttle
Title
Executive Director
Phone
(304) 258-3096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X WV Primary

Addresses

Primary practice location

106 Sand Mine Rd
Suite #1
Berkeley Springs, WV 25411-7457

Mailing address

106 Sand Mine Rd
Suite #1
Berkeley Springs, WV 25411-7457
Phone (304) 258-3096

Other identifiers 1

IdentifierTypeStateIssuer
0030693002MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Senior Life Services of Morgan County Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1134599616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SAND MINE RD",
            "address_2": "SUITE #1",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254117457",
            "telephone_number": "304-258-3096",
            "fax_number": "304-258-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SAND MINE RD",
            "address_2": "SUITE #1",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254117457",
            "telephone_number": "304-258-3096",
            "fax_number": "304-258-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIFE SERVICES OF MORGAN COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "TUTTLE",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-258-3096",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030693002",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Springs, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.