PREMIUM MARTIAL ARTS WV LLC (NPI# 1083171078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083171078 |
| Entity Type | Organization |
| Organization Name | PREMIUM MARTIAL ARTS WV LLC |
| Practice Address |
963 Dunbar Village Plz Dunbar WV 25064-3137 |
| Mailing Address |
602 Crossroads Vlg Nitro WV 25143-2054 |
| Practice Telephone | 3048070251 |
| Mailing Telephone | 3048070251 |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |
| Authorized Official Name | JESSICA LYNN MADDEN (OWNER/INSTRUCTOR) |
| Authorized Official Telephone | 3048070251 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
963 DUNBAR VILLAGE PLZ |
| City | DUNBAR |
| State | WV |
| Zip Code | 25064-3137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184087 | Janice Carol Brown | Technician | 106 Everette Lane, Dunbar, WV 25064 | 2020-11-03 |
| 1912328154 | Misty Ferguson | Physical Therapy Assistant | 501 Caldwel Lane, Dunbar, WV 25064 | 2013-12-13 |
| 1154626349 | City of Dunbar | Non-emergency Medical Transport (VAN) | 210 12th St., Dunbar, WV 25064 | 2011-01-19 |
| 1366600439 | Csi Community Services Inc | Community/Behavioral Health | 1400 Ohio Ave Ste A, Dunbar, WV 25064 | 2008-05-27 |
| 1962604975 | Stephen O'keefe | Psychologist | 1215 Stewart Plaza, Dunbar, WV 25064 | 2007-06-01 |
| 1518031384 | Lisa Hicks | Speech-Language Pathologist | 1313 Dunbar Avenue, Dunbar, WV 25064 | 2006-11-20 |
| 1770662579 | Mahmood Partovi | Family Medicine | 210 11th Street, Dunbar, WV 25064 | 2006-11-03 |
| 1528166311 | Karen Ano Cruz | Occupational Therapist | 1313 Dunbar Ave, Dunbar, WV 25064 | 2006-09-20 |
| 1154381572 | John Vincent Merrifield | Family Medicine | 1100 Grosscup Avenue, Dunbar, WV 25064 | 2006-03-28 |
| 1073596284 | James S Morris | Chiropractor | 100 Westmoreland Office Center, Dunbar, WV 25064 | 2005-11-22 |
| Find all providers in zip 25064 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396255261 | Go Journey Journal, Inc. | Day Training, Developmentally Disabled Services | 11738 Maccorkle Ave, Charleston, WV 25315-1035 | 2017-10-05 |
| 1902205214 | Family Options Providers Inc. | Day Training, Developmentally Disabled Services | 550 N Eisenhower Dr Ste A, Beckley, WV 25801-3146 | 2014-08-22 |
| 1790199487 | County of Boone - Board of Health | Day Training, Developmentally Disabled Services | 213 Kenmore Dr, Danville, WV 25053-6890 | 2014-06-20 |
| 1598911638 | Preston County Sheltered Workship, Inc | Day Training, Developmentally Disabled Services | Rt 92 S Jennmar Road, Reedsville, WV 26547 | 2008-08-08 |
| 1235392556 | Vocational Services, Inc. | Day Training, Developmentally Disabled Services | 2178 Big Sandy Road, Amma, WV 25005 | 2008-07-07 |
| 1346401734 | Sheltered Workshop of Nicholas County | Day Training, Developmentally Disabled Services | 16810 Webster Rd., Po Drawer 730, Craigsville, WV 26205-0730 | 2008-06-19 |
| 1871761312 | Job Squad, Inc. | Day Training, Developmentally Disabled Services | 102 Second Street, Bridgeport, WV 26330 | 2008-02-19 |
| 1649457367 | Buckhannon-upshur Work Adjustment Center,inc. | Day Training, Developmentally Disabled Services | Rr 2 Box 62, Buckhannon, WV 26201-9503 | 2008-01-24 |
| 1548470412 | Global Access LLC | Day Training, Developmentally Disabled Services | 25 Estill Dr, Charleston, WV 25314-1523 | 2007-05-22 |
| 1003024522 | Harrison County Sheltered Workshop, Inc. | Day Training, Developmentally Disabled Services | 1430 Cost Ave, Stonewood, WV 26301-4879 | 2007-05-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.