Provider Demographics
NPI:1902205214
Name:FAMILY OPTIONS PROVIDERS INC.
Entity Type:Organization
Organization Name:FAMILY OPTIONS PROVIDERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WALKER-MUNCY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LSW, CFAS
Authorized Official - Phone:304-254-9610
Mailing Address - Street 1:550 N EISENHOWER DR STE A
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3146
Mailing Address - Country:US
Mailing Address - Phone:304-254-9610
Mailing Address - Fax:304-254-9099
Practice Address - Street 1:550 N EISENHOWER DR STE A
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3146
Practice Address - Country:US
Practice Address - Phone:304-254-9610
Practice Address - Fax:304-254-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV355251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810011262Medicaid