Provider Demographics
NPI:1184961443
Name:WVSU METRO AREA AGENCY ON AGING
Entity type:Organization
Organization Name:WVSU METRO AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-720-6858
Mailing Address - Street 1:1 DUNBAR PLZ
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-3038
Mailing Address - Country:US
Mailing Address - Phone:304-720-6858
Mailing Address - Fax:304-720-6864
Practice Address - Street 1:1 DUNBAR PLZ
Practice Address - Street 2:SUITE 102
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-3038
Practice Address - Country:US
Practice Address - Phone:304-720-6858
Practice Address - Fax:304-720-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management