Provider Demographics
NPI:1104351451
Name:SUMMERS COUNTY COMMISSION
Entity type:Organization
Organization Name:SUMMERS COUNTY COMMISSION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:(BILL)
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-466-7104
Mailing Address - Street 1:120 BALLENGEE ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-2469
Mailing Address - Country:US
Mailing Address - Phone:304-309-5504
Mailing Address - Fax:304-466-7146
Practice Address - Street 1:120 BALLENGEE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-2469
Practice Address - Country:US
Practice Address - Phone:304-309-5504
Practice Address - Fax:304-466-7146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health