Provider Demographics
NPI:1821265257
Name:THE CHILDREN'S HOME OF WHEELING, INC.
Entity type:Organization
Organization Name:THE CHILDREN'S HOME OF WHEELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-233-2367
Mailing Address - Street 1:14 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6654
Mailing Address - Country:US
Mailing Address - Phone:304-233-2367
Mailing Address - Fax:304-233-3246
Practice Address - Street 1:14 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6654
Practice Address - Country:US
Practice Address - Phone:304-233-2367
Practice Address - Fax:304-233-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV174322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810005153Medicaid
WV0158345000Medicaid
WV0158345001Medicaid
WV3810005252Medicaid