Provider Demographics
NPI:1497974828
Name:TAYLOR COUNTY SENIOR CITIZENS, INC.
Entity Type:Organization
Organization Name:TAYLOR COUNTY SENIOR CITIZENS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-265-4555
Mailing Address - Street 1:RR 2 BOX 514
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-9664
Mailing Address - Country:US
Mailing Address - Phone:304-265-4555
Mailing Address - Fax:304-265-6083
Practice Address - Street 1:RR 2 BOX 514
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-9664
Practice Address - Country:US
Practice Address - Phone:304-265-4555
Practice Address - Fax:304-265-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV61551251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0030784000Medicaid