Provider Demographics
NPI:1285850172
Name:LINCOLN COUNTY OPPORTUNITY COMPANY, INC.
Entity Type:Organization
Organization Name:LINCOLN COUNTY OPPORTUNITY COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:304-824-3448
Mailing Address - Street 1:360 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25523-1412
Mailing Address - Country:US
Mailing Address - Phone:304-824-3448
Mailing Address - Fax:304-824-7662
Practice Address - Street 1:360 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25523-1412
Practice Address - Country:US
Practice Address - Phone:304-824-3448
Practice Address - Fax:304-824-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0004741001251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0004741001Medicaid