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POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC NPI 1154406296


NPI Information

NPI: 1154406296
Provider Name: POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC

Doing Business As: POTOMAC CENTER INC

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
ONE BLUE STREET
ROMNEY, WV
ZIP 26757
Phone: (304) 822-3861
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POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC is an intermediate care facility mentally retarded in Romney, WV. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. POTOMAC COMPREHENSIVE DIAGNOSTIC AND GUIDANCE CENTER INC NPI is 1154406296. The provider is registered as an organization entity type.
The provider Is Doing Business As Potomac Center Inc.

The provider's business location address is:

ONE BLUE STREET
ROMNEY, WV
ZIP 26757
Phone: (304) 822-3861
Fax: (304) 822-4297

The provider's authorized official is David Plowright .
The authorized official title is Executive Director and has the following contact phone number (304) 822-3861.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesWVDHHR214WEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10003198002MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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