Provider Demographics
NPI:1508023532
Name:MORGANTOWN PRIVATE DUTY LLC
Entity Type:Organization
Organization Name:MORGANTOWN PRIVATE DUTY LLC
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RPH
Authorized Official - Phone:304-296-6600
Mailing Address - Street 1:829 FAIRMONT RD STE 206
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-3892
Mailing Address - Country:US
Mailing Address - Phone:304-296-6600
Mailing Address - Fax:304-296-6800
Practice Address - Street 1:829 FAIRMONT RD STE 206
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-3892
Practice Address - Country:US
Practice Address - Phone:304-296-6600
Practice Address - Fax:304-296-6800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDS AT HOME CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2187-2641253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care