Provider Demographics
NPI:1508260647
Name:COALFIELD COMMUNITY ACTION PARTNERSHIP, INC. (CM)
Entity Type:Organization
Organization Name:COALFIELD COMMUNITY ACTION PARTNERSHIP, INC. (CM)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-235-1701
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-1406
Mailing Address - Country:US
Mailing Address - Phone:304-235-1701
Mailing Address - Fax:304-235-1706
Practice Address - Street 1:1626 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3007
Practice Address - Country:US
Practice Address - Phone:304-235-1701
Practice Address - Fax:304-235-1706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0030685000Medicaid