Provider Demographics
NPI:1144575572
Name:AUGUSTA LEVY LEARNING CENTER, INC.
Entity Type:Organization
Organization Name:AUGUSTA LEVY LEARNING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGEN
Authorized Official - Middle Name:WYNEMA
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-242-6722
Mailing Address - Street 1:PO BOX 6711
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0914
Mailing Address - Country:US
Mailing Address - Phone:304-242-6722
Mailing Address - Fax:304-242-6822
Practice Address - Street 1:210 ANTHONI AVE STE 300
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6403
Practice Address - Country:US
Practice Address - Phone:304-242-6722
Practice Address - Fax:304-242-6822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency