Provider Demographics
NPI:1578871687
Name:VETERANS HEALTH ADMINISTRATION
Entity Type:Organization
Organization Name:VETERANS HEALTH ADMINISTRATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LAND
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:304-926-6001
Mailing Address - Street 1:104 ALEX LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2952
Mailing Address - Country:US
Mailing Address - Phone:304-926-6001
Mailing Address - Fax:304-429-0287
Practice Address - Street 1:104 ALEX LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2952
Practice Address - Country:US
Practice Address - Phone:304-926-6001
Practice Address - Fax:304-429-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009427442865M2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital