Provider Demographics
NPI:1376713610
Name:FOXCREST, INC.
Entity Type:Organization
Organization Name:FOXCREST, INC.
Other - Org Name:THE FAMILY TREE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:CALA, CNHA, FACHCA
Authorized Official - Phone:304-387-0101
Mailing Address - Street 1:144 FOX LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:WV
Mailing Address - Zip Code:26034-1600
Mailing Address - Country:US
Mailing Address - Phone:304-387-0101
Mailing Address - Fax:304-387-0313
Practice Address - Street 1:144 FOX LN
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:WV
Practice Address - Zip Code:26034-1600
Practice Address - Country:US
Practice Address - Phone:304-387-0101
Practice Address - Fax:304-387-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV38010010668251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health