Provider Demographics
NPI:1821421991
Name:CARRIAGE INN HOME CARE OF WEST VIRGINIA, INC.
Entity Type:Organization
Organization Name:CARRIAGE INN HOME CARE OF WEST VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-813-3931
Mailing Address - Street 1:210 THREE SPRINGS DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3815
Mailing Address - Country:US
Mailing Address - Phone:304-914-4473
Mailing Address - Fax:304-914-3090
Practice Address - Street 1:210 THREE SPRINGS DR
Practice Address - Street 2:SUITE 2
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3815
Practice Address - Country:US
Practice Address - Phone:304-914-4473
Practice Address - Fax:304-914-3090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHS OF WINTERSVILLE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-13
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
517139Medicare Oscar/Certification