Provider Demographics
NPI:1538382551
Name:CATHOLIC CHARITIES WEST VIRGINIA INC.
Entity type:Organization
Organization Name:CATHOLIC CHARITIES WEST VIRGINIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELOI
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:304-905-9870
Mailing Address - Street 1:7 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 13TH ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3310
Practice Address - Country:US
Practice Address - Phone:304-233-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2801007000Medicaid