NPIMap

Organization Active NPI

Pride Community Services, Inc.

  • Attendant Care Provider
  • Logan, WV
National Provider Identifier
1922374883
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Legal business name
PRIDE COMMUNITY SERVICES, INC.
Practice address
699 Stratton St
Logan, WV 25601-4020
Phone
(304) 752-2686
Fax
(304) 752-1047
NPI assigned
Mar 26, 2012
Last updated
Apr 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Authorized official

Name
Reginald Jones
Title
Executive Director
Phone
(304) 752-6868

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NU
Attendant Care Provider 3747A0650X 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
3810022733MedicaidWV

Other names 1

  • PRIDE IN LOGAN COUNTY, INC. Former legal business name

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": "1332720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1922374883",
    "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": "304-752-2686",
            "fax_number": "304-752-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-752-6868"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022733",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIDE IN LOGAN COUNTY, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 11, 2012; 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.