Provider Demographics
NPI:1275722134
Name:A SPECIAL TOUCH FOR SENIORS
Entity Type:Organization
Organization Name:A SPECIAL TOUCH FOR SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:G
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:304-744-4940
Mailing Address - Street 1:325 4TH AVE STE 4
Mailing Address - Street 2:P.O. BOX 8534
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1266
Mailing Address - Country:US
Mailing Address - Phone:304-746-5600
Mailing Address - Fax:304-746-5620
Practice Address - Street 1:325 4TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1266
Practice Address - Country:US
Practice Address - Phone:304-746-5600
Practice Address - Fax:304-746-5620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1041-2009251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001084Medicaid