NPI 1013311133

Square One Family Networks Corp

Organisation Case Management Agency Fairmont, WV

Practice location

Address: 1708 Locust Ave STE 201, Fairmont, WV 26554-1332
Phone: (304) 694-7636
Fax: (888) 977-2130

Authorised official

Name: Jayme Dawn Dodd
Title: Owner, Executive Director
Phone: (304) 694-7636

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence AP00944042 (WV)

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Registry record

NPI: 1013311133
Entity type: Organization
NPI issued: 17 Oct 2014
Record last updated: 17 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.