Provider Demographics
NPI:1477717056
Name:RIGHT FROM THE START PROJECT
Entity Type:Organization
Organization Name:RIGHT FROM THE START PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-623-9308
Mailing Address - Street 1:330 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2910
Mailing Address - Country:US
Mailing Address - Phone:304-623-9308
Mailing Address - Fax:304-623-9364
Practice Address - Street 1:330 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2910
Practice Address - Country:US
Practice Address - Phone:304-623-9308
Practice Address - Fax:304-623-9364
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRISON CLARKSBURG HEALTH DEPT.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0021463001Medicaid