Provider Demographics
NPI:1073632642
Name:BARBOUR COUNTY SENIOR CENTER, INC
Entity Type:Organization
Organization Name:BARBOUR COUNTY SENIOR CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAENELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-457-1041
Mailing Address - Street 1:101 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-1105
Mailing Address - Country:US
Mailing Address - Phone:304-457-4545
Mailing Address - Fax:304-457-2017
Practice Address - Street 1:101 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-1105
Practice Address - Country:US
Practice Address - Phone:304-457-4545
Practice Address - Fax:304-457-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0030532002Medicaid