Provider Demographics
NPI:1356449375
Name:PACE TRAINING AND EVALUATION CENTER, INC
Entity Type:Organization
Organization Name:PACE TRAINING AND EVALUATION CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-599-0513
Mailing Address - Street 1:PO BOX 4241
Mailing Address - Street 2:420 PLEASANT HILLS AVE
Mailing Address - City:STAR CITY
Mailing Address - State:WV
Mailing Address - Zip Code:26504-4241
Mailing Address - Country:US
Mailing Address - Phone:304-599-0513
Mailing Address - Fax:304-599-0671
Practice Address - Street 1:420 PLEASANT HILL AVE
Practice Address - Street 2:
Practice Address - City:STAR CITY
Practice Address - State:WV
Practice Address - Zip Code:26505-2042
Practice Address - Country:US
Practice Address - Phone:304-599-0513
Practice Address - Fax:304-599-0671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV05357001251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005357001Medicaid