Provider Demographics
NPI:1629201306
Name:BURLINGTON UNITED METHODIST FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:BURLINGTON UNITED METHODIST FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-289-6010
Mailing Address - Street 1:RR 3 BOX 3122
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-9413
Mailing Address - Country:US
Mailing Address - Phone:304-289-6010
Mailing Address - Fax:304-289-6015
Practice Address - Street 1:105 S 2ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1529
Practice Address - Country:US
Practice Address - Phone:304-289-6010
Practice Address - Fax:304-289-6015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1036-7271251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD505750700Medicaid