Provider Demographics
NPI:1972548899
Name:POCAHONTAS CONTINUOUS CARE CENTER, INC.
Entity Type:Organization
Organization Name:POCAHONTAS CONTINUOUS CARE CENTER, INC.
Other - Org Name:POCAHONTAS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:RR 1
Practice Address - Street 2:
Practice Address - City:MARLINTON
Practice Address - State:WV
Practice Address - Zip Code:24954-9801
Practice Address - Country:US
Practice Address - Phone:304-799-7375
Practice Address - Fax:304-799-7378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
001703823OtherMOUNTAIN STATE
2111214OtherUNITED - MAMSI
2507226OtherAETNA-HMO
WV0004082000Medicaid
=========OtherHNFS-TRICARE
=========OtherAETNA-NONHMO
=========OtherCARELINK
2111214OtherUNITED - MAMSI