Provider Demographics
NPI:1235518440
Name:COMMUNITY ACCESS INCORPORATED
Entity Type:Organization
Organization Name:COMMUNITY ACCESS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:304-549-0561
Mailing Address - Street 1:PO BOX 8885
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-0885
Mailing Address - Country:US
Mailing Address - Phone:304-549-0561
Mailing Address - Fax:
Practice Address - Street 1:7095 SMITH CREEK RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-7519
Practice Address - Country:US
Practice Address - Phone:304-549-0561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP00939412251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable