NPIMap

Organization Active NPI

Pride Community Services, Inc.

  • In Home Supportive Care Agency
  • Logan, WV
National Provider Identifier
1295230001
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PRIDE COMMUNITY SERVICES, INC.
Practice address
699 Stratton St
Logan, WV 25601-4020
Phone
(304) 752-6868
Fax
(304) 752-1047
NPI assigned
Mar 26, 2018
Last updated
Mar 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Authorized official

Name
Lisha Whitt
Title
Executive Director
Phone
(304) 752-6868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

699 Stratton St
Logan, WV 25601-4020

Mailing address

PO Box 1346
Logan, WV 25601-1346
Phone (304) 752-6868

Other identifiers 1

IdentifierTypeStateIssuer
0030732000MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Pride Community Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1295230001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1346",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256011346",
            "telephone_number": "304-752-6868",
            "fax_number": "304-752-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 STRATTON ST",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256014020",
            "telephone_number": "304-752-6868",
            "fax_number": "304-752-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "WHITT",
        "authorized_official_first_name": "LISHA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-752-6868"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030732000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.