NPI 1104228006

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) 657-8943

Registered specialties (2)

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence AP00944042 (WV)

Other Case Management providers in West Virginia →

Early Intervention Provider Agency

Agencies Taxonomy 252Y00000X Licence 332608 (WV)

Other Early Intervention Provider Agency providers in West Virginia →

Registry record

NPI: 1104228006
Entity type: Organization
NPI issued: 23 Sep 2014
Record last updated: 8 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.